No abstract available.
Gastrointestinal Hemorrhage ; Intussusception

It was suggested that temporary vascular insufficiency within the wall of the colon causes iachemic colitis. So, motivated by this fact, we studied and analyzed 15 cases of iachemic colitis, which were confirmed by the diagnostic criteria of Nagasako(1982), through 32 months from January, 1993 to August, 1995 at Our Lady of Mercy Hospital, Incheon.(continue...)
Colitis ; Colitis, Ischemic* ; Colon

It was suggested that temporary vascular insufficiency within the wall of the colon causes iachemic colitis. So, motivated by this fact, we studied and analyzed 15 cases of iachemic colitis, which were confirmed by the diagnostic criteria of Nagasako(1982), through 32 months from January, 1993 to August, 1995 at Our Lady of Mercy Hospital, Incheon.(continue...)
Colitis ; Colitis, Ischemic* ; Colon

May-Thurner syndrome, which refers to an iliofemoral venous thrombosis caused by chronic compression of the left common iliac vein by the right common iliac artery, usually manifests as left lower extremity pain and swelling. The syndrome is particularly evident in patients with health conditions including obesity, smoking, pregnancy, surgery, or prolonged immobility. Antiphospholipid syndrome consists of arterial or venous thrombosis and the association of lupus anticoagulant or anticardiolipin antibodies. Most common clinical manifestations include pregnancy loss and deep vein thrombosis. We experienced a rare case of May-Thurner syndrome concurrent with antiphospholipid syndrome, secondary to systemic lupus erythematosus. The patient was treated successfully by catheter-directed percutaneous thrombectomy, venous thrombolysis, and stent insertion, followed by oral anticoagulant therapy.
Antibodies, Anticardiolipin ; Antiphospholipid Syndrome ; Humans ; Iliac Artery ; Iliac Vein ; Lower Extremity ; Lupus Coagulation Inhibitor ; Lupus Erythematosus, Systemic ; May-Thurner Syndrome ; Obesity ; Postthrombotic Syndrome ; Pregnancy ; Smoke ; Smoking ; Stents ; Thrombectomy ; Venous Thrombosis

Paget's disease of bone (PDB) is a disorder featuring high-level bone turnover associated with the presence of disorganized and immature bone tissue with excessive levels of fibrosis. The risk of deformity is very high. The etiology of PDB is not well understood, but includes both genetic and environmental factors among which is bone trauma. Hypercalcemia can occur as a complication of PDB in patients who are immobilized and dehydrated. However, to date, no case of severe hypercalcemia with metastatic calcifications in multiple organs has been reported in any PDB patient. The drugs of choice for treatment of PDB are bisphosphonates. These drugs effectively suppress bone turnover. Patients with extensive PDB may require higher doses of bisphosphonates, and acquired resistance to a particular bisphosphonate may be overcome by use an alternative drug. Here, we report a case of suspicion of PDB. The patient presented with hypercalcemia and metastatic calcifications and his condition improved dramatically after treatment with zoledronic acid.
Bone and Bones ; Congenital Abnormalities ; Diphosphonates ; Fibrosis ; Humans ; Hypercalcemia* ; Imidazoles ; Osteitis Deformans ; Wounds and Injuries

Paget's disease of bone (PDB) is a disorder featuring high-level bone turnover associated with the presence of disorganized and immature bone tissue with excessive levels of fibrosis. The risk of deformity is very high. The etiology of PDB is not well understood, but includes both genetic and environmental factors among which is bone trauma. Hypercalcemia can occur as a complication of PDB in patients who are immobilized and dehydrated. However, to date, no case of severe hypercalcemia with metastatic calcifications in multiple organs has been reported in any PDB patient. The drugs of choice for treatment of PDB are bisphosphonates. These drugs effectively suppress bone turnover. Patients with extensive PDB may require higher doses of bisphosphonates, and acquired resistance to a particular bisphosphonate may be overcome by use an alternative drug. Here, we report a case of suspicion of PDB. The patient presented with hypercalcemia and metastatic calcifications and his condition improved dramatically after treatment with zoledronic acid.
Bone and Bones ; Congenital Abnormalities ; Diphosphonates ; Fibrosis ; Humans ; Hypercalcemia* ; Imidazoles ; Osteitis Deformans ; Wounds and Injuries

Emphysematous prostatic abscess is a very rare form of prostatitis. Emphysematous prostatic abscess due to Klebsiella pneumoniae may have a poor prognosis according to a few previous reports. We report a rare case of successfully treated emphysematous prostatic abscess with cystitis due to Klebsiella pneumoniae in a 50-yr-old man with 15-yr history of diabetes mellitus. The patient was referred to the emergency room of our hospital. The KUB film revealed gas shadows in the lower pelvic area suggestive of emphysematous cystitis or emphysematous prostatic abscess. The gas was mainly occupying the prostate and was also seen in the bladder on pelvic CT. The patient was successfully treated with long-term antibiotic use and additional percutaneous drainage of the abscess. Emphysematous prostatic abscess may be misdiagnosed as emphysematous cystitis due to the similar location of gas shadows on radiography. Computerized tomography and transrectal ultrasonography are helpful in making the diagnosis of emphysematous prostatic abscess. Appropriate use of effective antibiotics with drainage of pus is the best treatment. This case emphasizes the importance of timely and accurate diagnosis followed by appropriate treatment in emphysematous prostatic abscess in diabetic patients.
Abscess ; Anti-Bacterial Agents/therapeutic use ; Cystitis/diagnosis ; Diabetes Mellitus/complications ; Drainage ; Emphysema/diagnosis/*microbiology ; Human ; Klebsiella Infections/*diagnosis/drug therapy ; Klebsiella pneumoniae/*metabolism ; Male ; Middle Aged ; Prostate/*microbiology ; Prostatic Diseases/*diagnosis/microbiology/radiography

PURPOSE: In order to investigate the survival rate, causes of death, and the predictors of death in hemodialysis patients with chronic renal failure. METHODS: Among the 3,462 patients who started hemodialysis in Asan Medical Center between May 1989 and December 1999, we selected 674 patients who were closely observed at least for 3 months since they began hemodialysis as an initial replacement therapy for chronic renal failure. Demographic and clinical characteristics, including diabetes mellitus, hepatitis viral marker, and laboratory findings at the beginning of hemodialysis were retrospectively analyzed RESULTS: The mean age of the patients was 51.0+/-14.8 years, and their sex ratio was 1.4:1(M:F). The proportion of patients with diabetic nephropathy was 34.4%. The mean follow-up period was 34.2+/-28.1 months and 117 patients died(17%). The greatest number of patients were found to have died of cardiac problems(23%), followed by cerebrovascular disease(16.2%), infection(13.7%) and malignant disease(11.1%). The survival rate of the 674 patients was found to range from 1 to 10 years:96% at 1 year, 88% at 2, 73% at 5, and 54% at 10 years. In order to determine the independent predictors of death, we used Cox proportional hazards model. The predictors of death in hemodialysis patients were found to be (i) male(Relative risk(RR)=1.46, p=0.06), (ii) people over 60 years of age(RR=1.54, p=0.03), diabetes mellitus(RR=1.45, p=0.06), and (iii) low level of serum creatinine(RR=0.65, p < 0.001). CONCLUSION: Cardiovascular disease and infectious diseases were important causes of death in hemodialysis patients. Old age and low serum creatinine at the beginning of hemodialysis were significant predictors of death.
Biomarkers ; Cardiovascular Diseases ; Cause of Death ; Chungcheongnam-do ; Communicable Diseases ; Creatinine ; Diabetes Mellitus ; Diabetic Nephropathies ; Follow-Up Studies ; Hepatitis ; Humans ; Kidney Failure, Chronic ; Proportional Hazards Models ; Renal Dialysis* ; Retrospective Studies ; Sex Ratio ; Survival Analysis* ; Survival Rate

Stenotrophomonas maltophilia (previously named Xanthomonas maltophilia) is an aerobic, non-fermentive, Gram-negative bacillus that is wide spread in the environment. It was considered to be an organism with limited pathogenic potential, which was rarely capable of causing diseases in human other than those who were in debilitated or immunocompromised state. More recent studies have established that Stenotrophomonas maltophilia can behave as a true pathogen. Endocarditis due to this organism is rare, and only 24 cases of Stenotrophomonas maltophilia endocarditis have been reported in the medical literature. Most cases were associated with risk factors, including intravenous drug abuse, dental treatment, infected intravenous devices, and previous cardiac surgery. We present a case with two episodes of Stenotrophomonas maltophilia endocarditis after mitral valve prosthesis implantation, which was treated with antibiotics initially, and a combination of antibiotics and surgery later. To our knowledge, this is the first case of repetitive endocarditis due to Stenotrophomonas maltophilia.
Adult ; Anti-Bacterial Agents/*therapeutic use ; Bioprosthesis/adverse effects/*microbiology ; Endocarditis, Bacterial/*drug therapy/physiopathology ; Gentamicins/therapeutic use ; Gram-Negative Bacterial Infections/*drug therapy/physiopathology ; Heart Valve Prosthesis/adverse effects/*microbiology ; Humans ; Male ; Mitral Valve ; Recurrence ; Stenotrophomonas maltophilia/*drug effects ; Treatment Outcome ; Trimethoprim-Sulfamethoxazole Combination/*therapeutic use ; Vancomycin/therapeutic use

OBJECTIVE: This study sought to investigate independent predictive factors for subclinical atherosclerosis in Korean patients with rheumatoid arthritis (RA). METHODS: We used high-resolution B-mode ultrasonography to measure the carotid artery intima-media thickness (IMT) and carotid plaque in 367 patients with RA. Detailed information on the demographic characteristics, cardiovascular (CV) risk factors, and RA disease characteristics were collected on all subjects. The relationship of the carotid artery IMT and carotid plaque to relevant clinical and laboratory variables were examined. RESULTS: Old age and male sex had the most significant association with increased IMT and presence of plaque than other factors. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and mKHAQ (Korean version of modified health assessment questionnaire) were significantly associated with both increased IMT and presence of plaque after univariate analysis adjusting for age and sex. A multivariable logistic regression analysis revealed that ESR and TJC68 were independent factors associated with the presence of plaque (p<0.001 and p=0.019, respectively). There was a significant linear correlation between the number of plaques and ESR (p<0.001 and R2=0.07). CONCLUSION: Our results indicated that markers of systemic inflammation contributed significantly to subclinical atherosclerosis in patients with RA. We emphasize the need for aggressive control of RA disease activity in patients who persistently demonstrate highly elevated ESR levels.
Arthritis, Rheumatoid ; Atherosclerosis ; Blood Sedimentation ; C-Reactive Protein ; Cardiovascular Diseases ; Carotid Arteries ; Cohort Studies ; Humans ; Inflammation ; Logistic Models ; Male ; Risk Factors