2.Albumin-refractory Transudative Ascites for the Diagnosis of Protein-losing Gastric Cancer: A Case Report
Naoya MIZUTANI ; Hiroyuki MORI ; Tsuneaki KENZAKA
An Official Journal of the Japan Primary Care Association 2024;47(3):89-98
A 63-year-old man with schizophrenia presented to our hospital with a chief complaint of anorexia and edema in the lower legs for the past month. Upper gastrointestinal endoscopy revealed a gross type 3 gastric carcinoma (pathology: tubular adenocarcinoma, moderately differentiated type) from the upper gastric body to the gastric antrum. His serum total protein level was 4.7 g/dL and serum albumin concentration was 1.5 g/dL. Contrast-enhanced computed tomography, magnetic resonance imaging, and examination of ascites showed no evidence of distant metastases. Hypoalbuminemia was refractory to albumin administration with no evidence of cancerous peritonitis on staging laparoscopy. Gastrointestinal scintigraphy confirmed protein leakage from the gastric tumor into the gastrointestinal tract. We reviewed the literature and identified 34 other cases of protein-losing gastric cancer, which were used to comprehensively elucidate its clinical features. Borrmann type 0 or 1 tumors of the gastric body or antecubital area, with a maximum tumor diameter of nearly 10 cm and a cauliflower-like appearance, are highly suggestive of protein-losing gastric cancer. In conclusion, 99mTc-HSA scintigraphy and staging laparoscopy should be performed aggressively to differentiate protein-losing gastric cancer tumor from cancerous peritonitis.
3.A Patient with Cat-scratch Disease Diagnosed by Detailed Medical History and Physical Examination
Syunsuke Kusano ; Tsuneaki Kenzaka ; Tetsuya Yamamoto ; Hozuka Akita
An Official Journal of the Japan Primary Care Association 2017;40(3):156-159
Cat-scratch disease occurs after a scratch from a cat infected with Bartonella henselae. We report a 64-year-old man with cat-scratch disease who had swollen lymph nodes. Consequently, metastasis of a malignant tumor was suspected as the most likely cause in the differential diagnosis. Therefore, the diagnosis was delayed and several diagnostic examinations were performed. Although diagnosis was difficult in this case, an accurate diagnosis was achieved by taking a detailed medical history, including questioning about pet ownership, and by carefully examining the lower limbs including the femoral region. These steps are important to diagnose cat-scratch disease.
4.Hepatic computed tomography changes caused by amiodarone.
The Korean Journal of Internal Medicine 2015;30(5):745-746
No abstract available.
Aged, 80 and over
;
Amiodarone/*adverse effects
;
Anti-Arrhythmia Agents/*adverse effects
;
Atrial Fibrillation/diagnosis/*drug therapy
;
Drug-Induced Liver Injury/*etiology/radiography
;
Female
;
Humans
;
Liver/*drug effects/radiography
;
Predictive Value of Tests
;
*Tomography, X-Ray Computed
5.Purple urine bag syndrome in a patient with a urethral balloon catheter and a history of ileal conduit urinary diversion.
The Korean Journal of Internal Medicine 2015;30(3):420-420
No abstract available.
Aged
;
Anti-Bacterial Agents/therapeutic use
;
Bacteria/metabolism
;
Catheter-Related Infections/diagnosis/drug therapy/*microbiology
;
Color
;
Equipment Design
;
Escherichia coli Infections/diagnosis/drug therapy/*microbiology
;
Female
;
Humans
;
Intestines/*microbiology
;
Pigments, Biological/metabolism
;
Treatment Outcome
;
Tryptophan/metabolism
;
Urinary Bladder Neoplasms/surgery
;
Urinary Catheterization/adverse effects/*instrumentation
;
*Urinary Catheters
;
*Urinary Diversion
;
Urinary Tract Infections/diagnosis/drug therapy/*microbiology
;
Urine/chemistry/microbiology