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1.
Clin Endosc ; 49(3): 282-8, 2016 May.
Article in English | MEDLINE | ID: mdl-26888410

ABSTRACT

BACKGROUND/AIMS: Colonoscopic perforations have been managed with exploratory laparotomy, and have resulted in some morbidity and mortality. Recently, laparoscopic surgery is commonly performed for this purpose. The aim of this study was to compare the outcomes of several management strategies for iatrogenic colonoscopic perforations. METHODS: We retrospectively reviewed the medical records of patients who had been treated for colonoscopic perforation between January 2004 and April 2013 at CHA Bundang Medical Center in Korea. RESULTS: A total of 41 patients with colonoscopic perforation were enrolled. Twenty patients underwent conservative management with a success rate of 90%. Surgical management was performed in 23 patients including two patients who were converted to surgical management after the failure of the initial conservative management. Among 14 patients who underwent surgery at 8 hours after the perforation, there was no considerable difference in adverse outcomes between the laparotomy group and the laparoscopic surgery group. The medical costs and claim rate were 1.45 and 1.87 times greater in the exploratory laparotomy group, respectively. CONCLUSIONS: Conservative management of colonoscopic perforation could be an option for patients without overt symptoms of peritonitis or with a small defect size. If surgical management is required, laparoscopic surgery may be considered as the initial procedure even with a delayed diagnosis.

2.
Korean J Gastroenterol ; 65(1): 52-6, 2015 Jan.
Article in English | MEDLINE | ID: mdl-25603855

ABSTRACT

Nodular regenerative hyperplasia (NRH) is an uncommon liver condition characterized by diffuse transformation of the hepatic parenchyma into regenerative nodules without fibrosis. Portal vasculopathy caused by abnormal hepatic venous flow may induce hepatocyte hyperplasia, which forms regenerative nodules. Underlying diseases or certain drugs may also be the cause of NRH. This condition is often underdiagnosed as the patients remain asymptomatic until development of portal hypertension, and histopathologic confirmation by liver biopsy is the only way of making a definite diagnosis. The management mainly involves prevention and treatment of the complications of portal hypertension. The frequency of diagnosis of NRH has increased rapidly in recent years, however, only a few cases have been reported in Korea. Here, we report on a case of NRH of the liver combined with toxic hepatitis.


Subject(s)
Chemical and Drug Induced Liver Injury/diagnosis , Focal Nodular Hyperplasia/diagnosis , Alanine Transaminase/analysis , Aspartate Aminotransferases/analysis , Bilirubin/blood , Chemical and Drug Induced Liver Injury/complications , Chemical and Drug Induced Liver Injury/pathology , Duodenal Ulcer/pathology , Endoscopy, Digestive System , Female , Focal Nodular Hyperplasia/complications , Focal Nodular Hyperplasia/pathology , Humans , Liver/enzymology , Liver/pathology , Magnetic Resonance Imaging , Middle Aged , Tomography, X-Ray Computed
3.
Korean J Hematol ; 47(1): 74-6, 2012 Mar.
Article in English | MEDLINE | ID: mdl-22479281

ABSTRACT

Pneumatosis intestinalis (PI) is a rare condition characterized by multiple pneumocysts in the submucosa or subserosa of the bowel. Here, we report a rare case of asymptomatic PI after chemotherapy induction in an 18-yr-old man with B lymphoblastic leukemia with recurrent genetic abnormalities. The patient was treated conservatively and recovered without complications. The possibility of PI should be considered as a complication during or after chemotherapy for hematologic malignancies. Conservative treatment should be considered unless there are complications, including peritonitis, bowel perforation, and severe sepsis.

4.
Int J Hematol ; 95(1): 107-11, 2012 Jan.
Article in English | MEDLINE | ID: mdl-22167655

ABSTRACT

Human herpesvirus 8-positive (HHV-8⁺) and Epstein-Barr virus-positive (EBV⁺) germinotropic lymphoproliferative disorder (GLD) is extremely rare and occurs most commonly in immunocompetent persons who are human immunodeficiency virus (HIV)-seronegative. It is also recognized as a favorable response to conventional chemotherapy. Here, we report a case of a 75-year-old man with an incidentally found mass in the neck, compatible with GLD, which was detected by positron emission tomography (PET). Computed tomography (CT) scan, PET, and bone marrow studies showed only the left neck mass and no evidence of metastasis. Excisional biopsy of the mass was performed. The patient received four courses of CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) therapy. After these treatments, he remained disease-free for 19 months. To the best of our knowledge, only five cases of HHV-8⁺, EBV⁺ GLD have been documented. This is the first such case report in Asia.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Germinal Center/pathology , Herpesviridae Infections/complications , Herpesvirus 4, Human/isolation & purification , Herpesvirus 8, Human/isolation & purification , Lymphoma/complications , Lymphoma/drug therapy , Aged , Cyclophosphamide/therapeutic use , Doxorubicin/therapeutic use , Germinal Center/virology , Head and Neck Neoplasms/complications , Head and Neck Neoplasms/drug therapy , Head and Neck Neoplasms/pathology , Head and Neck Neoplasms/virology , Herpesviridae Infections/virology , Humans , Lymphoma/pathology , Lymphoma/virology , Male , Prednisone/therapeutic use , Vincristine/therapeutic use
5.
Ultrasound Med Biol ; 37(9): 1444-51, 2011 Sep.
Article in English | MEDLINE | ID: mdl-21775047

ABSTRACT

The roles of body fat and muscle masses for developing cardiometabolic disorders are opposed to each other. The aim of this study was to analyze whether abdominal visceral to thigh muscle thickness ratio (AVTMR) measured by ultrasonography can be a simple yet useful index assessing the disproportion between visceral fat and thigh muscle, and whether it is associated with carotid atherosclerosis. This was an observational study performed on 15 healthy men and 68 men with newly-diagnosed type 2 diabetes. Using ultrasonography, abdominal visceral thickness, mid-thigh muscle thickness and carotid artery intima-media thickness (CA-IMT) were determined. The visceral fat amount and lipid-rich muscle mass were increased and metabolic profile was poorer across AVTMR tertiles. The AVTMR was associated an increased CA-IMT independent of traditional risk factors. The AVTMR measure using ultrasonography might be a relevant index identifying individuals at an increased risk of cardiovascular disease.


Subject(s)
Carotid Artery Diseases/diagnostic imaging , Intra-Abdominal Fat/diagnostic imaging , Aged , Aged, 80 and over , Analysis of Variance , Case-Control Studies , Diabetes Mellitus, Type 2/diagnostic imaging , Humans , Linear Models , Male , Muscle, Skeletal/diagnostic imaging , Predictive Value of Tests , Risk Factors , Thigh/diagnostic imaging , Tomography, X-Ray Computed , Tunica Intima/diagnostic imaging , Tunica Media/diagnostic imaging , Ultrasonography
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