A case of renal amyloidosis with crescentic glomerulonephritis associated with rheumatoid arthritis is described. A 60-year-old female with 15 years' history of rheumatoid arthritis developed nephrotic syndrome followed by rapid deterioration of renal function. Glomerular amyloid deposition and sclerotic change was present in kidney biopsy specimen and crescentic change was found in 85% of the glomerulus. Electron microscopic finding of glomerulus showed randomly oriented, rigid-appearing, long nonbranching fibrils. The patient was treated with intravenous high-dose methylprednisolone pulses combined with intravenous cyclophosphamide followed by oral corticosteroids. Three months after the above treatment, renal function gradually improved, reaching serum creatinine level to 2.5 mg/dL. But the nephrotic range proteinuria persisted.
Adrenal Cortex Hormones ; Amyloidosis* ; Arthritis, Rheumatoid* ; Biopsy ; Creatinine ; Cyclophosphamide ; Female ; Glomerulonephritis* ; Humans ; Kidney ; Methylprednisolone ; Middle Aged ; Nephrotic Syndrome ; Plaque, Amyloid ; Proteinuria

Liver abscess can be caused by bacterial, parasitic, or fungal infection. Amebic abscesses are more common, but pyogenic abscesses account for three quarters of hepatic abscess in developed countries. Most common pathogens of the pyogenic liver abscess are Escherichia coli, Klebsiella pneumoniae, Bacteroides, Enterococci, Streptococci, and Staphylococci. However, liver abscess caused by Salmonella species has rarely been reported. We experienced a case of Salmonella liver abscess which improved after antibiotic therapy and percutaneous drainage. The patient was 52 years-old man who had an episode of intermittent fever, chills and epigastric pain for 2 weeks. He was diagnosed as liver cirrhosis eight years ago and diabetes three years ago. Salmonella group D, non-typhi was cultured from blood and pus from the liver respectively at the same time. With percutaneous drainage and susceptible antibiotic therapy, liver abscess decreased in size with improvements in fever and abdominal pain.
Humans ; Liver/radiography/ultrasonography ; Liver Abscess, Pyogenic/*diagnosis/microbiology ; Male ; Middle Aged ; Salmonella Infections/*diagnosis

BACKGROUND/AIMS: The aim of this study was to compare the patient's satisfaction and tolerance of transnasal (TN) and transoral (TO) endoscopy prospectively. METHODS: 120 patients were assigned to undergo TN (age: 49.5, M : F=65 : 55) or TO (age: 47.4, M : F=63 : 57) endoscopy according to their wishes. RESULTS: The patients' satisfaction was higher in the TN group than in the TO group (8.45 vs. 4.95, p <0.05). The degree of choking sensation, nausea, and throat soreness was lower in the TN group than the TO group. There was no difference in endoscopists' satisfaction between the two groups. The duration for TN was longer than for TO. Epistaxis and nasal pain were the common complications in the TN group. All complications were mild and were relieved spontaneously. An endoscopic examination could be completed in all patients in the TO group. In the TN group, examination failure was quite common in the early phase but the incidence decreased with increasing experience. It took the experience of at least 20 cases for the endoscopist to adapt to the TN route. CONCLUSIONS: TN endoscopy is believed to be a comfortable and safe procedure for improving the patients' satisfaction and for reducing the level of inconvenience.
Airway Obstruction ; Endoscopy* ; Epistaxis ; Humans ; Incidence ; Nausea ; Pharynx ; Prospective Studies ; Sensation