Eosinophilic gastroenteritis is a rare disease of unknown etiology. It is characterized by the infiltration of the gastrointestinal tract by mature eosinophils, and increased peripheral eosinophil count and associated with various food allergies. Clinical manifestations were related to the site of histologic infiltration in the wall and the segment of the involved gastrointestinal tract. Recently, the authors experienced one case of eosinophilic gastroenteritis of the small bowel with spontaneous rupture that was managed by segmental resection of ileum and end to end anastomosis. Four years previous, he has undergone segmental resection of the ileum due to ileum perforation of unknown etiology. The peripheral blood eosinophil count of this case was normal but the IgE level was elevated. Microscopically, there was a dense infiltration of eosinophils throughout the entire thickness of the ileal wall, particularly in the muscle layer. The patient recovered well, but had one episode of abdominal pain with diarrhea and those symptoms were improved following the administration of corticosteroids. A brief review of the etiology, pathology, clinical features, diagnosis and management of this disease is presented.
Abdominal Pain ; Adrenal Cortex Hormones ; Diagnosis ; Diarrhea ; Eosinophils* ; Food Hypersensitivity ; Gastroenteritis* ; Gastrointestinal Tract ; Humans ; Ileum ; Immunoglobulin E ; Pathology, Clinical ; Rare Diseases ; Rupture* ; Rupture, Spontaneous

The word "Delayed" in the legend of Figure 2 should have been written as "Controls."

BACKGROUND: Several antibiotics can be used to treat ventilator-associated pneumonia caused by carbapenem-resistant A. baumannii (CRAB-VAP) including high-dose sulbactam. However, the effectiveness of high-dose sulbactam therapy is not well known. We report our experience with high-dose sulbactam for treatment of CRAB-VAP. METHODS: Medical records of patients with CRAB-VAP who were given high-dose sulbactam between May 2013 and June 2015 were reviewed. RESULTS: Fifty-eight patients with CRAB-VAP were treated with high-dose sulbactam. The mean age was 72.0 ± 15.2 years, and the acute physiology and chronic health evaluation II (APACHE II) score was 15.1 ± 5.10 at the time of CRAB-VAP diagnosis. Early clinical improvement was observed in 65.5% of patients, and 30-day mortality was 29.3%. Early clinical failure (odds ratio [OR]: 8.720, confidence interval [CI]: 1.346-56.484; p = 0.023) and APACHE II score ≥ 14 at CRAB-VAP diagnosis (OR: 10.934, CI: 1.047-114.148; p = 0.046) were associated with 30-day mortality. CONCLUSIONS: High-dose sulbactam therapy may be effective for the treatment of CRAB-VAP. However, early clinical failure was observed in 35% of patients and was associated with poor outcome.
Acinetobacter baumannii* ; Acinetobacter* ; Anti-Bacterial Agents ; APACHE ; Diagnosis ; Humans ; Medical Records ; Mortality ; Pneumonia, Ventilator-Associated* ; Sulbactam*

No abstract available.
Anemia, Refractory* ; Cyclosporine*

Purpose: We report a rare case of allergic contact dermatitis after the use of a non-preservative 0.5% moxifloxacin ophthalmic solution.Case summary: A 60-year-old male presented with bacterial corneal ulceration of the right eye. He was treated with 50 mg/mL of fortified cefazolin and 14 mg/mL of tobramycin that were tapered as the corneal lesion improved after 1 month, and 0.5% moxifloxacin application was started. After 2 weeks of moxifloxacin treatment, the patient developed conjunctival injection, lid swelling, redness, and itching in the right eye. An allergic reaction was suspected and moxifloxacin administration was immediately stopped. The symptoms improved after the administration of oral antihistamines, 0.5% loteprednol eye drops, and steroid combination ointment. Conclusions Patients treated with 0.5% topical moxifloxacin should be monitored for allergic contact dermatitis, even if preservative-free eye drops are used.

PURPOSE: To investigate the natural course of iatrogenic Horner's syndrome induced by procedures in the neck and upper thoracic areas. METHODS: Four patients who developed ptosis after undergoing procedures near the neck and upper thoracic areas were diagnosed with iatrogenic Horner's syndrome. We evaluated the clinical courses of the patients retrospectively. We also performed a systematic Medline search through Pubmed to find patients with iatrogenic Horner's syndrome. We summarized onset times and natural courses of reported cases. RESULTS: In two cases, ptosis improved completely within 2 and 4 months. In the other two cases, ptosis persisted through the last follow-up. As a result of our Medline search, we identified 51 cases in 47 journals. In 31 patients (62%), symptoms improved from 17 minutes to 3 months after surgery. However, in 20 patients (38%), symptoms persisted for up to 20 months. CONCLUSIONS: Although the mechanism underlying iatrogenic Horner's syndrome induced by procedures in the neck and upper thoracic area is not clearly understood, the syndrome may occur when the sympathetic nerve pathway is damaged directly or indirectly. Surgical correction should be postponed because this rare complication may resolve spontaneously within 4 months. The surgeon should explain the possibility of Horner's syndrome to patients after neck and upper thoracic surgery.
Catheterization ; Follow-Up Studies ; Horner Syndrome ; Humans ; Neck ; Retrospective Studies ; Stellate Ganglion ; Thoracic Surgery

Tooth wear, one of the physiological changes in the elderly patient's mouth, generally does not require treatment, but requires prosthodontic restoration when occlusal disharmony, poor masticatory function, pulp exposure occurs. One of the primary considerations in prosthodontic restoration for tooth wear is vertical dimension. It is necessary to make an accurate diagnosis and analysis, correct judgement of the interdental relationship for predictive treatment plan. A step-by-step approach considering dental care for aged is also required. In this case, a 93-year-old male patient presented with worn dentition and mobility of existing fixed dental prosthesis. After diagnosis and evaluation, maxillary rehabilitation without any change in the occlusal vertical dimension was performed and this shows satisfactory results both functionally and morphologically.
Aged* ; Dental Care for Aged ; Dental Prosthesis* ; Dentition* ; Diagnosis ; Humans ; Male ; Mouth ; Rehabilitation ; Tooth Wear ; Vertical Dimension

PURPOSE: This study aimed to discover a way to increase the bond strength between bis-acryl resins, using a comparison of the shear bond strengths attained from bis-acryl resins treated with light curing, pressure, oxygen inhibition, and heat. MATERIALS AND METHODS: Self-cured bis-acryl resin was used as both a base material and as a repair material. Seventy specimens were distributed into seven groups according to treatment methods: pressure - stored in a pressure cooker at 0.2 Mpa; oxygen inhibition- applied an oxygen inhibitor around the repaired material,; heat treatment - performed heat treatment in a dry oven at 60degrees C, 100degrees C, or 140degrees C. The shear bond strength was measured with a universal testing machine, and the shear bond strength (MPa) was calculated from the peak load of failure. A comparison of the bond strength between the repaired specimens was conducted using one-way ANOVA and Tukey multiple comparison tests (alpha=.05). RESULTS: There were no statistically significant differences in the shear bond strength between the control group and the light curing, pressure, and oxygen inhibition groups. However, the heat treatment groups showed statistically higher bond strengths than the groups treated without heat, and the groups treated at a higher temperature resulted in higher bond strengths. Statistically significant differences were seen between groups after different degrees of heat treatment, except in groups heated at 100degrees C and 140degrees C. CONCLUSION: Strong bonding can be achieved between a bis-acryl base and bis-acryl repair material after heat treatment.
Hot Temperature* ; Oxygen*

The idiopathic long-QT syndrome is an infrequent inherited disorder, characterized by prolonged QT interval and by the occurrence of life-threatening tachyarrhythmia, particularly in association with emotional or physical stree. In its characteristic presentation, with obvious QT prolongation and stree induced syncope with torsades de points, the diagnosis is straightforward for physicians aware of the disease. But sometimes in cases of borderline QT prolongation and vague symptom, a correct diagnosis is delayed and frequently misdiagnosed as a seizure disorder. The mortality of untreated symptomatic patients with LQTS exceeds 20% in the year after their first syncopal episode and aapproaches 50% within 10 years. But this high mortality rate has been significantly reduced by the use of pharmacological or surgical antiadrenergic therapy or both. So early detection of the disease and antiadrenergic treatment sympathetic innervation to the heart. Second, there was intrinsic gene abnormality in the mechanisms responsible for cardiac repolarization. We report one case of LQTS in a 24 years old female patient who had been suffering from stree related syncope. Her initial EKG had prologed QT interval(588msec) and increased QT intrval dispersion(200msec). In the Holter monitor, long and short cycle sequence induced (pause-dependent) torsades de pointes was detected. She has been treated by beta-blocker and has maintained her condition without recurrence of the symptoms.
Diagnosis ; Electrocardiography ; Epilepsy ; Female ; Heart ; Humans ; Long QT Syndrome ; Mortality ; Recurrence ; Syncope ; Tachycardia ; Torsades de Pointes ; Young Adult

BACKGROUND/AIMS: Gastric stasis in migraineurs remains controversial. The aim of this study is to investigate gastric emptying (GE) time, and any associations between GE parameters and dyspeptic symptoms among patients with functional dyspepsia (FD) and migraine without any gastrointestinal symptoms during the interictal period. METHODS: We enrolled 27 migraine patients, 32 FD patients and 12 healthy people as controls, and performed GE scintigraphy as gastric function test. Gastrointestinal symptoms were evaluated in the FD and migraine. RESULTS: The age-adjusted mean gastric half-emptying time in FD (125.51 +/- 52.55 minutes) patients was longer than in migraineurs (100.82 +/- 23.94 minutes, P = 0.035) and controls (95.25 +/- 23.29 minutes, P = 0.021). The percentage of gastric retention was higher in FD than in migraine. However, migraineurs did not show an obvious delayed gastric emptying or an increase of gastric retention when compared to the normal controls. The association between each dyspeptic symptom and GE parameters was not significant, but postprandial fullness and early satiety showed a tendency of delayed GE. In migraineurs, GE time did not show significant association with nausea and vomiting during interictal periods. CONCLUSIONS: Delayed GE does not appear to be a mechanism that patients with FD and migraine have in common. Migraineurs without dyspepsia during interictal period had normal GE, and further study for association with FD should be investigated.
Dyspepsia ; Gastric Emptying ; Gastroparesis ; Humans ; Migraine Disorders ; Nausea ; Retention (Psychology) ; Vomiting