Actinomycosis is a chronic suppurative and granulomatous disease caused by a Gram-negative anaerobic bacterium, Actinomyces israelii, which is among the normal flora of the oral cavity and gastrointestinal tract of humans and animals. It is characterized by sulfur granule formation and can involve the cervicofacial area, chest, abdomen, and pelvis. The most common predisposing factors are the presence of an intrauterine contraceptive device, previous trauma, appendectomy, colon diverticulum, and gastrointestinal perforation. Primary gastric actinomycosis is an extremely rare disease. Three cases of gastric actinomycosis have been reported in people who had a subtotal gastrectomy for stomach cancer in Korea. We report a case of primary gastric actinomycosis in a 59-year-old man with untreatable hepatocelluar carcinoma. His actinomycosis was cured with penicillin therapy.
Abdomen ; Actinomyces ; Actinomycosis ; Animals ; Appendectomy ; Carcinoma, Hepatocellular ; Diverticulum, Colon ; Gastrectomy ; Gastrointestinal Tract ; Humans ; Intrauterine Devices ; Korea ; Middle Aged ; Mouth ; Pelvis ; Penicillins ; Rare Diseases ; Stomach Neoplasms ; Stomach Ulcer ; Sulfur ; Thorax

Pseudocystocolonic fistula is a rare, but occasionally lethal event in acute pancreatitis. Surgery has been the mainstay treatment, but recent literature has reported improvements in non-surgical therapies. Here, we report a case of acute pancreatitis complicated by pseudocystocolonic fistula that was treated by non-surgical means. A 58-year-old man, who consumed excessive alcohol, was admitted with severe abdominal pain. Abdominal computed tomography (CT) showed multiple pancreatic pseudocysts and fistula in the descending colon associated with acute pancreatitis. The fistula opening was identified by colonoscopy, and a diagnosis of pseudocystocolonic fistula was made. The pseudocyst was lavaged with saline through a percutaneous cystic drainage catheter and the patient became asymptomatic. Follow-up abdominal CT confirmed the disappearance of the colonic fistula and multiple pseudocysts. We also provide a review of the most effective non-surgical therapies for pseudocystocolonic fistula associated with acute pancreatitis.
Abdominal Pain ; Catheters ; Colon ; Colon, Descending ; Colonoscopy ; Drainage ; Fistula ; Follow-Up Studies ; Humans ; Middle Aged ; Pancreatic Pseudocyst ; Pancreatitis

BACKGROUND: Peroxisome proliferators-activated receptor gamma (PPARgamma) is a member of the nuclear hormone receptor superfamily of ligand-activated transcription factors and known to play a role in regulating the expression of numerous genes involved in lipid metabolism, metabolic syndrome, inflammation, and atherosclerosis. The PPARgamma2 Pro12Ala polymorphism has recently been shown to be associated with diabetic nephropathy. In this study, we evaluated the relationship between PPARgamma2 Pro12Ala polymorphism and type 2 diabetic nephropathy whose duration of diabetes was over 10 years. METHODS: We conducted a case-control study, which enrolled 367 patients with type 2 diabetes. Genotyping of PPARgamma2 Pro12Ala polymorphism was performed using polymerase chain reaction followed by digestion with Hae III restriction enzyme. RESULTS: The genotype or allele frequencies of PPARgamma2 Pro12Ala polymorphism were not significantly different in diabetic patients with or without diabetic nephropathy. The genotype frequencies in terms of diabetic retinopathy and macrovascular complications such as coronary artery disease or stroke were not different either. Interestingly, nephropathy patients with Ala/Pro genotype showed lower C-peptide levels than those of Pro/Pro genotype. CONCLUSION: Our results suggest that PPARgamma2 Pro12Ala polymorphism is not associated with diabetic nephropathy in type 2 diabetic patients.
Atherosclerosis ; C-Peptide ; Case-Control Studies ; Coronary Artery Disease ; Diabetic Nephropathies ; Diabetic Retinopathy ; Digestion ; Gene Frequency ; Genotype ; Humans ; Inflammation ; Lipid Metabolism ; Peroxisomes ; Polymerase Chain Reaction ; PPAR gamma ; Stroke ; Transcription Factors

Hypertriglyceridemia-induced pancreatitis is a rare, but serious, complication of pregnancy. We report a case of acute pancreatitis associated with type V hyperlipoproteinemia in pregnancy. A 36-year-old primigravida was admitted at 16 weeks of gestation with severe abdominal pain. Chemical analysis showed high serum pancreatic enzymes and very high serum triglyceride. Abdominal magnetic resonance imaging (MRI) showed diffuse swelling of the pancreas and a peripancreatic fluid collection. A diagnosis of acute pancreatitis with type V hyperlipoproteinemia was made. She recovered from the acute pancreatitis with conservative management and the serum triglyceride decreased rapidly with dietary restriction of fat, insulin/glucose, fenofibrate, and omega-3. We review the management of hypertriglyceridemia-induced acute pancreatitis in pregnancy.
Abdominal Pain ; Adult ; Fenofibrate ; Humans ; Hyperlipoproteinemia Type V ; Hypertriglyceridemia ; Magnetic Resonance Imaging ; Pancreas ; Pancreatitis ; Pregnancy