Fournier's gangrene is a rare infection with high mortality rate. it consists of a mixed bacterial infectin of the skin, subcutaneous tissues and superficial fascia of the perinium and genitalia. Old patients especially with diabetes mellitus, alcoholism and maligancy are more affected. This disease requires prompt treatment: early diagnosis, broad spectrum antibiotic therapy, nutritional support and immediate extensive surgial debridement are necessary We report one case of Fournier's gangrene associated with diabetes mellitus.
Alcoholism ; Debridement ; Diabetes Mellitus ; Early Diagnosis ; Fournier Gangrene* ; Genitalia ; Humans ; Mortality ; Nutritional Support ; Skin ; Subcutaneous Tissue

Emphysematous gastritis is a rare disease characterized by air in the wall of the stomach due to gas-forming microorganisms. This lethal entity was first described by Fraenkel in 1889. Forty-six cases have been reported so far in the literature. The predisposing factors include corrosive ingestion, immunocompromized state, alcohol abuse, cancer, diabetes and so on. Computed tomography is the procedure of choice for early diagnosis. Only prompt diagnosis and treatment can avoid mortality. Initial antibiotic therapy should cover gram-negative organisms and anaerobes. We report a case of emphysematous gastritis in a 41-year-old man with Klatskin's tumor.
Adult ; Alcoholism ; Causality ; Diagnosis ; Early Diagnosis ; Eating ; Gastritis* ; Humans ; Klatskin's Tumor* ; Mortality ; Rare Diseases ; Stomach

BACKGROUND: Community-acquired pneumonia(CAP) remains a leading cause of morbidity and mortality worldwide. Recently, the evolution of drug-resistant microorganisms has become a serious problem in CAP management. Specific antimicrobial therapy is the cornerstone of CAP management. However, obtaining an accurate etiologic diagnosis clinically is not easy and empirical antimicrobial treatment is usually administered prior to the correct microbiologic diagnosis. In this study, the clinical usefulness of empirical CAP treatment was investigated. METHODS: A total 35 cases were studied prospectively over a 16-month period in Mokpo Catholic Hospital from Dec. 1995 to Mar. 1997. The microbiologic diagnosis was made by sputum, blood culture, a specific serum antibody test and an immunologic study. RESULTS: The causative organisms were isolated in 10 (30%) out of 33 cases: 8 cases and 1 case on the sputum culture and blood culture respectively, and 1 case by an indirect hemagglutinin test. 12 cases had underlying diseases: pulmonary tuberculosis 4, alcoholism 4, diabetes mellitus 3, and liver cirrhosis 1. Antimicrobial treatment was given empirically and all cases recovered. CONCLUSION: A definite microbiologic diagnosis before commencing the appropriate treatment in CAP is not straightforward. Empirical therapy according to a clinical assessment is important and helpful. However, every effort to make the correct etiologic diagnosis should be taken.
Alcoholism ; Diabetes Mellitus ; Diagnosis ; Hemagglutinins ; Jeollanam-do* ; Liver Cirrhosis ; Mortality ; Pneumonia* ; Prospective Studies ; Sputum ; Tuberculosis, Pulmonary

Alcohol abuse is related to a wide variety of medical complications including liver diseases, pancreatitis, cardiovascular diseases, immunological abnormalities, malignant neoplasms, endocrine disturbances, and kidney problems. The liver is the organ most severely affected by alcoholism. Alcoholic liver disease (ALD) remains a major cause of morbidity and mortality in Korea. The mainstay of therapy for alcohol-related medical problems is cessation of drinking. This article summarizes alcohol-related medical complications and treatment with focus on alcoholic liver injury.
Alcoholics ; Alcoholism* ; Cardiovascular Diseases ; Drinking ; Humans ; Kidney ; Korea ; Liver ; Liver Diseases ; Liver Diseases, Alcoholic ; Mortality ; Pancreatitis

OBJECTIVES: Alcohol withdrawal delirium is a serious clinical condition with high mortality rate if not treated. This study was to examine whether readily available clinical variables can predict the development of alcohol withdrawal delirium. METHODS: The authors performed a retrospective study by reviewing charts of 566 patients who had been admitted for alcohol dependence. The cases were divided into two groups: delirium group (n=40) and control group (n=40). We compared baseline characteristics and serum analysis data at admission between two groups. We used logistic regression to predict risk factors for alcohol withdrawal delirium among potential risk factors. RESULTS: The delirium group had significantly lower hemoglobin, hematocrit, platelet counts, and potassium level than countrol group. Presence of previous withdrawal delirium history, AST, GGTP, and bilirubin level of delirium group were significantly higher than those of control group. Among potential risk factors, past history of withdrawal delirium, decreased hemoglobin, elevated bilirubin level, and number of previous detoxification were predictable factors of the development of alcohol withdrawal delirium by 72.5%. CONCLUSION: Our results suggest that the infomation obtained at admission can be useful to predict the development of alcohol withdrawal delirium. Also, it makes the individualization of detoxification strategies possible.
Alcohol Withdrawal Delirium* ; Alcoholism ; Bilirubin ; Delirium ; gamma-Glutamyltransferase ; Hematocrit ; Humans ; Logistic Models ; Mortality ; Platelet Count ; Potassium ; Retrospective Studies ; Risk Factors

OBJECTIVES: Alcohol withdrawal delirium is a serious clinical condition with high mortality rate if not treated. This study was to examine whether readily available clinical variables can predict the development of alcohol withdrawal delirium. METHODS: The authors performed a retrospective study by reviewing charts of 566 patients who had been admitted for alcohol dependence. The cases were divided into two groups: delirium group (n=40) and control group (n=40). We compared baseline characteristics and serum analysis data at admission between two groups. We used logistic regression to predict risk factors for alcohol withdrawal delirium among potential risk factors. RESULTS: The delirium group had significantly lower hemoglobin, hematocrit, platelet counts, and potassium level than countrol group. Presence of previous withdrawal delirium history, AST, GGTP, and bilirubin level of delirium group were significantly higher than those of control group. Among potential risk factors, past history of withdrawal delirium, decreased hemoglobin, elevated bilirubin level, and number of previous detoxification were predictable factors of the development of alcohol withdrawal delirium by 72.5%. CONCLUSION: Our results suggest that the infomation obtained at admission can be useful to predict the development of alcohol withdrawal delirium. Also, it makes the individualization of detoxification strategies possible.
Alcohol Withdrawal Delirium* ; Alcoholism ; Bilirubin ; Delirium ; gamma-Glutamyltransferase ; Hematocrit ; Humans ; Logistic Models ; Mortality ; Platelet Count ; Potassium ; Retrospective Studies ; Risk Factors

Adult ; Alcoholism ; epidemiology ; Biopsy ; Female ; Follow-Up Studies ; Humans ; Liver Cirrhosis ; epidemiology ; Male ; Middle Aged ; Mortality ; Singapore

Chylous effusion is an unusual complication of malignant neoplasm, usually lymphoma. In cases with cancer, the tumor was usually extensive, and the prognosis was invariably poor with a one year mortality rate of 80%. It was also reported that chylous effusion could also result from liver cirrhosis. The incidence of this complication was reported to be 0.5% in patients with liver cirrhosis and ascites. Here we report a case of 62 year old male with chronic alcoholism history who presented with abdom-inal distension and right cervical mass. He was subsequently diagnosed as non-Hodgkin's lymphoma and chylous ascites with liver cirrhosis and treated with chemotherapy. In spite of treatment, lymphoma progressed and the patient expired.
Alcoholism ; Ascites ; Chylous Ascites* ; Drug Therapy ; Humans ; Incidence ; Liver Cirrhosis* ; Liver* ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Male ; Middle Aged ; Mortality ; Prognosis

Alcohol abuse is related to diverse medical problems including neuropsychiatric problems, malignant neoplasms, cardiovascular diseases and liver diseases. The liver is the organ most severely affected by alcoholism. Alcoholic liver disease (ALD) remains a major cause of morbidity and mortality world wide. The spectrum of ALD is not uniform including steatosis, alcoholic hepatitis and cirrhosis with increasing severity. Recent research has elucidated the mechanisms of alcohol-induced liver injury, offers the prospect of advances in the management of alcoholic liver disease. Interactions between acetaldehyde, reactive oxygen species, inflammatory mediators and genetic factors appear to play important roles in the development of ALD. The mainstay of therapy for ALD is cessation of drinking. Nutritional support has been shown to play a positive role in ALD. In this article, the most recent data on the efficacy of treatment of ALD including corticosteroid, anti-inflammatory agents and antioxidant were reviewed.
Acetaldehyde ; Alcoholics* ; Alcoholism* ; Anti-Inflammatory Agents ; Cardiovascular Diseases ; Drinking ; Fibrosis ; Hepatitis, Alcoholic ; Humans ; Liver ; Liver Diseases ; Liver Diseases, Alcoholic* ; Mortality ; Nutritional Support ; Reactive Oxygen Species

Alcohol consumption is a serious health issue in Korea in terms of the amount consumed and the behavior related to its consumption. Aldehyde dehydrogenase 2 (ALDH2) is a key enzyme in alcohol metabolism that degrades acetaldehyde to nontoxic acetic acid. The enzyme is coded by the ALDH2 gene, which is commonly polymorphic in East Asian populations. A point mutation in the ALDH2 gene (the rs671 allele) yields an inactive form of ALDH2 that causes acetaldehyde accumulation in the body after alcohol consumption, thereby inhibiting normal alcohol metabolism. Individuals who are homozygous for polymorphism in ALDH2 tend to refrain from drinking alcohol, decreasing their chances of developing alcoholism and exposure to the associated risks. Mendelian randomization (MR) studies have demonstrated that alcohol consumption predicted by ALDH2 genotype is causally related to cardiovascular risks. Moreover, recent MR studies suggest that the ALDH2 variant has mechanistic effects on some disease outcomes or mortality through increased blood levels of acetaldehyde, showing differences therein between heterozygotes (ALDH2*2*2) and homozygotes (ALDH2*1*2) in those who consume alcohol. Accordingly, consideration of ALDH2 genotype in alcohol prevention programs is warranted. In conclusion, strategies that incorporate genetic information and provide an evidential basis from which to help people make informed decisions on alcohol consumption are urgently required.
Acetaldehyde ; Acetic Acid ; Alcohol Drinking* ; Alcoholism ; Aldehyde Dehydrogenase* ; Asian Continental Ancestry Group ; Drinking ; Genotype ; Heterozygote ; Homozygote ; Humans ; Korea* ; Mendelian Randomization Analysis ; Metabolism ; Mortality ; Point Mutation ; Random Allocation