Primary gastric actinomycosis is an extremely rare disease and less than 20 cases are reported in literature. We experienced a case of gastric actinomycosis in the 63-year-old woman who had subtotal gastrectomy for early gastric cancer(type IIc) 7 month ago. Endoscopic biopsy from elevated lesion on stoma was found to show the neutrophilic infiltration and sulfur granule. She placed on tetracycline for 30 days. Follow up endoscopy showed no abnormality. We report this case with literature review. (Koresn J Gastrointest Endosc 18: 757~ 760, 1996)
Actinomycosis ; Biopsy ; Endoscopy ; Female ; Follow-Up Studies ; Gastrectomy* ; Humans ; Middle Aged ; Neutrophils ; Rare Diseases ; Stomach Neoplasms* ; Sulfur ; Tetracycline

Fibromatous tumors of the ovary are considered to originate from specialized ovarianstromal cells and account for approximately 4% of all ovarian neoplasms. Most ovarianfibromatous tumors are benign, but infrequently there are histologically malignant appearances.Malignant fibromatous tumor can be categorized into two separate types of tumorsrelating to prognosis, cellular fibroma and fibrosarcoma. The cellular fibroma has one tothree mitotic counts per 10 high power fields(HPF). Unless an adhesion or rupture appearson this tumor, recurrence should not happen after operation. Furthermore, where themitotic count per 10 HPF is over four, it is classified as a very bad fibrosarcoma case interms of prognosis.We have met a case of large ovarian fibrosarcoma with has ten mitotic counts per10 HPF. We hereby report this case with the brief review of literatures.
Female ; Fibroma ; Fibrosarcoma* ; Ovarian Neoplasms ; Ovary ; Prognosis ; Recurrence ; Rupture

The brain houses vital hormonal regulatory structures such as the hypothalamus and pituitary gland, which may confer unique susceptibilities to critical illness-related corticosteroid insufficiency (CIRCI) in patients with neurological disorders. In addition, the frequent use of steroids for therapeutic purposes in various neurological conditions may lead to the development of steroid insufficiency. This abstract aims to highlight the significance of understanding these relationships in the context of patient care and management for physicians. Neurological disorders may predispose patients to CIRCI due to the role of the brain in hormonal regulation. Early recognition of CIRCI in the context of neurological diseases is essential to ensure prompt and appropriate intervention. Moreover, the frequent use of steroids for treating neurological conditions can contribute to the development of steroid insufficiency, further complicating the clinical picture. Physicians must be aware of these unique interactions and be prepared to evaluate and manage patients with CIRCI and steroid insufficiency in the context of neurological disorders. This includes timely diagnosis, appropriate steroid administration, and careful monitoring for potential adverse effects. A comprehensive understanding of the interplay between neurological disease, CIRCI, and steroid insufficiency is critical for optimizing patient care and outcomes in this complex patient population.

Mannitol, derived from mannose sugar, is crucial in treating patients with elevated intracranial pressure (ICP). Its dehydrating properties at the cellular and tissue levels increase plasma osmotic pressure, which is studied for its potential to reduce ICP through osmotic diuresis. While clinical guidelines support mannitol use in these cases, the best approach for its application continues to be debated. Important aspects needing further investigation include: 1) bolus administration versus continuous infusion, 2) ICP-based dosing versus scheduled bolus, 3) identifying the optimal infusion rate, 4) determining the appropriate dosage, 5) establishing fluid replacement plans for urinary loss, and 6) selecting monitoring techniques and thresholds to assess effectiveness and ensure safety.Due to the lack of adequate high-quality prospective research data, a comprehensive review of recent studies and clinical trials is crucial. This assessment aims to bridge the knowledge gap, improve understanding of effective mannitol use in elevated ICP patients, and provide insights for future research. In conclusion, this review aspires to contribute to the ongoing discourse on mannitol application. By integrating the latest findings, this review will offer valuable insights into the function of mannitol in decreasing ICP, thereby informing better therapeutic approaches and enhancing patient outcomes.