Actinomycosis infection can involve most part of the human body including mouth, cervicoface, chest, abdomen and pelvis. Cardiac involvement occurs in less than 2 percent of the infection of actinomyces israelii and pericardial involvement is rare. 34 year male was admitted because of chest pain and general weakness for several months. Echocardiography revealed akinesia of apex suggesting myocardial infarction and large pericardial effusion. Under the impression of pericardial effusion from tuberculosis infection, the patient was started on anti-tuberculosis medicine. Pericardial window operation with pericardial biopsy was performed 7 days later when the patient failed to show a significant improvement. Pericardial biopsy confirmed actinomycosis infection. During admission, the patient had a cerebral infarction with left hemiparesis. The patient was treated with high dose penicillin and improved symptomatically. Echocardiography showed resolution of pericardial effusion.
Abdomen ; Actinomyces ; Actinomycosis* ; Biopsy ; Cerebral Infarction* ; Chest Pain ; Echocardiography ; Human Body ; Humans ; Male ; Mouth ; Myocardial Infarction* ; Paresis ; Pelvis ; Penicillins ; Pericardial Effusion ; Thorax ; Tuberculosis*

Extramedullary hematopoiesis denotes blood cell production in hematopoietic tissue other than bone marrow. Myeloproliferative disorders, including myelofibrosis, polycythemia vera, essential thrombocythemia and chronic myelogenous leukemia (CML) are the most common cause of extramedullary hematopoiesis. Extramedullary hematopoiesis most commonly occurs in the spleen, liver and lymph nodes but has been reported in almost all sites of the body. Usually extramedullary hematopoiesis has been reported to involve liver, without forming a liver mass in a patient with CML. We report a patient with CML who had extramedullary hematopoiesis presenting as a liver mass established by ultrasound-guided biopsy.
Biopsy ; Blood Cells ; Bone Marrow ; Hematopoiesis, Extramedullary* ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Liver* ; Lymph Nodes ; Myeloproliferative Disorders ; Polycythemia Vera ; Primary Myelofibrosis ; Spleen ; Thrombocythemia, Essential

PURPOSE: Secondary bleeding is an inevitable and a troublesome complication of hemorrhoidectomy. This study analyzed the factors related to secondary bleeding after hemorrhoidectomy. METHODS: A total of 14,062 patients received a hemorrhoidectomy from Apr. 1999 to Apr. 2001. A retrospective study of 83 patients with secondary bleeding was done. At first, the doctors were divided into two groups. In one group, each doctor had performed more than 500 hemorrhoidectomies; in the other groups, each doctor had performed less than 500 hemorrhoidectomies. The incidence of secondary bleeding of the two groups was compared. Then, 155 patients without secondary bleeding were randomly selected as a control group. Clinical aspects and laboratory data were compared with those of the bleeding group. RESULTS: The total incidence of secondary bleeding was 0.6%. The incidence for the group with experienced doctors was 0.5%, that for the other group was 1.3%. When bleeding patients were compared with the control group, the proportion of patients who received a blood transfusion within 1 week before operation was 12.1% in the bleeding group and 2.6% in the control group. The postoperative WBC count was increased more in the bleeding group. The percentage treated with metronidazole was 12% compared with 25.3% in the control group. The incidences of bleeding according to operation sites were 19.6% in the right anterior, 12.2% in the left lateral, 10.9% in the right posterior, and 8.4% in the posterior portion. CONCLUSIONS: Secondary bleeding after a hemorrhoidectomy is more prevalent with less experienced doctors, recent history of blood transfusion, less use of metronidazole, and specific location of the hemorrhoid, such as the right anterior and the left lateral site of the hemorrhoid pile.
Blood Transfusion ; Hemorrhage* ; Hemorrhoidectomy* ; Hemorrhoids ; Humans ; Incidence ; Metronidazole ; Retrospective Studies

The incidence of colon cancer and cancer-related deaths has been increased in Korea. Because most colon cancers arise from colonic adenomatous polyps, it is important to detect these early and to resect such lesions, and so the incidence of endoscopic polypectomy has increased in Korea since 1970's. At present, conventional colonoscopy is the standard for evaluating the colon, and especially for the screening and treatment of colon tumor. However, the entire colon cannot be visualized during conventional colonoscopy in 5~15% of patients due to a redundant colon, an excessive loop or a history of abdominal surgery. To overcome these difficulties, many radiologic and endoscopic studies have been conducted and there are several recent reports that double balloon enteroscopy has been successfully used in cases of failed conventional colonoscopy. We report here on a case of laterally spreading tumor that was resected with double balloon enteroscopy in a severely redundant colon.
Adenomatous Polyps ; Colon ; Colonic Neoplasms ; Colonoscopy ; Double-Balloon Enteroscopy ; Humans ; Incidence ; Korea ; Mass Screening

The spontaneous regression of herniated cervical discs is not a well established phenomenon. However, we encountered the 3 cases of spontaneous regression of severe radiculopathic herniated cervical discs that were treated using a non-surgical method. Each of the patients were treated with a combination of manipulation, dry needling and analgesics. In each case, the symptoms improved within 12 months of treatment and magnetic resonance imaging (MRI) conducted at that time revealed marked regression of the herniated disc in all cases. These cases provide additional examples of spontaneous regression of herniated cervical discs documented by MRI following non-surgical treatment.
Analgesics ; Humans ; Intervertebral Disc Displacement ; Magnetic Resonance Imaging

We compared the therapeutic effects of concomitant chemoradiotherapy (CRT) using cisplatin to single radiotherapy (RT) in uterine cervical cancer. 34 cases of non-operable uterine cervical cancer were reviewed retrospectively from Mar, 1993 to May, 1996 in St. Mary' s Hospital. The patients were randomly selected to compare the effects of both methods. 22 patients were included in CRT group and 12 patients in RT group. The results were as follows: 1. The decrease of tumor size was not significant (2.17 cm in CRT and 1.95 cm in RT) (p=0.61), but the number of responders of CRT group was larger than that of RT group significantly (p<0.05). 2. The tumor markers showed no significant difference between CRT and RT groups (p>0.05) 3. The overall survival rate showed no difference between two groups (p>0.05). The disease-free survivals for 38 months were 17.02% in CRT and 11.36% in RT, but it was not significant (p>0.05). In conclusion, concomitant chemoradiotherapy showed better rate of response, but size of tumor decrease and tumor markers showed no difference. CRT might improve the overall survival and disease-free survival, although it was not significant in this study. The clinical significance of CRT remains to be determined in large randomized clinical trial.
Chemoradiotherapy ; Cisplatin ; Disease-Free Survival ; Humans ; Radiotherapy* ; Retrospective Studies ; Survival Rate ; Biomarkers, Tumor ; Uterine Cervical Neoplasms*

Morganella morganii is a facultative gram-negative and anaerobic rod. It may be a cause of devastating infections in neonates and immunocompromised hosts. Some bacterial infections such as Clostridium and Vibrio are associated with hemolysis. However, massive hemolysis caused by M. morganii sepsis has not yet been reported. We observed a 59-yr-old man who had chemotherapy-induced neutropenia and was found to have massive hemolysis and metabolic acidosis due to sepsis. He died 6 hr after admission in spite of aggressive treatment. Two sets of blood cultures revealed the growth of M. morganii. We report here that M. morganii sepsis can cause fatal massive hemolysis leading to death.
Antineoplastic Agents/adverse effects ; Bacteremia/*complications ; Enterobacteriaceae Infections/*complications ; *Hemolysis ; Humans ; Male ; Middle Aged ; *Morganella morganii ; Neutropenia/complications

Ischemic colitis is recognized as the most common vascular disorder of the intestines in the elderly. Correct diagnosis is usually made after the ischemic episide is over and ischemic colitis is frequently misdiagnosed. A case is presented in which an initial diagnosis of appendicitis was made. On operation, a tumor like mass was found in ascending colon. Pathological examination revealed ischemic colitis. We report a case of ischemic colitis in ascending colon mimicking colon cancer.
Aged ; Appendicitis ; Colitis, Ischemic* ; Colon* ; Colon, Ascending* ; Colonic Neoplasms* ; Diagnosis ; Humans ; Intestines

Toxoplasma lymphadenitis is the most common clinical manifestation of toxoplasmosis in an immunocompetent host. The cervical lymph nodes are the most commonly involved, whereas systemic manifestations are rare. The most common clinical presentations are asymptomatic or subclinical, with fever, maculopapular rash, and general malaise. In immunocompromised patients, the presentations may be devastating with disseminated disease resulting in encephalitis, myocarditis, and pneumonia. We are reporting a case of toxoplasma lymphadenitis in an immunocompetent host diagnosed by histologic and serologic evaluation.
Encephalitis ; Exanthema ; Fever ; Immunocompromised Host ; Lymph Nodes ; Lymphadenitis* ; Myocarditis ; Pneumonia ; Toxoplasma ; Toxoplasmosis*

Purpose: Deceased donor liver transplantation (DDLT) recipients in Korea are generally sicker due to an increasing organ shortage. In the present study, the risk factors for early 30-day liver graft failure after DDLT were identified. Methods: From August 2017 to February 2021, 265 adult DDLTs were performed. The characteristics of patients with and without 30-day graft failure were compared. Results: Liver graft failure occurred in 11 patients (17.7%) after DDLT. Baseline and perioperative characteristics of donors and recipients were not statistically significantly different between the 2 groups. The cumulative graft and overall survival rates at 6 months were 83.9% and 88.7%, respectively. Multivariate analysis showed ventilator support in the pretransplant period was a predisposing factor for 30-day graft failure after DDLT. Conclusion Present study indicates that cautious decision is required when allocating DDLT in critically ill patients on mechanical ventilatory support.