Colonization of the pre-transplant lung by multidrug-resistant bacteria affects short- and long-term outcomes of lung transplantation. However, there are no case reports on the colonization of a pre-transplant lung by drug-resistant Acinetobacter baumannii. We report a case of extensively drug resistant (XDR) A. baumannii colonization in the tracheobronchial tree that caused severe infectious complications after bilateral lung transplantation. A 23-year-old man diagnosed with bronchiolitis obliterans syndrome (BOS) 4 years earlier with a history of allogenic bone marrow transplantation for acute lymphoblastic leukemia was admitted to the hospital with dyspnea. Due to progressive hypercapnic respiratory failure, long-term mechanical ventilation was started after a tracheostomy was performed, and the patient underwent a bilateral lung transplantation to treat end-stage BOS. After the transplantation, the colonization of XDR A. baumannii caused severe bacterial pneumonia in the early postoperative period. Combined treatment with colistin and meropenem led to recovery from the pneumonia but caused drug-induced renal failure. Because many centers are willing to transplant candidates who are on mechanical ventilation or extracorporeal life support, the incidence of XDR A. baumannii colonization of pretransplant lungs is expected to increase. Further studies are needed to examine pre-transplant management strategies in patients colonized with XDR A. baumannii.
Acinetobacter baumannii* ; Bacteria ; Bone Marrow Transplantation ; Bronchiolitis Obliterans ; Colistin ; Colon* ; Drug Resistance ; Dyspnea ; Humans ; Incidence ; Lung ; Lung Transplantation* ; Pneumonia ; Pneumonia, Bacterial ; Postoperative Period ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Renal Insufficiency ; Respiration, Artificial ; Respiratory Insufficiency ; Tracheostomy ; Young Adult

BACKGROUND/OBJECTIVES: Doenjang, Korean traditional fermented soybean paste has been reported to have an anti-obesity effect. Because adipose tissue is considered a major source of inflammatory signals, we investigated the protective effects of Doenjang and steamed soybean on oxidative stress and inflammation in adipose tissue of diet-induced obese mice. MATERIALS/METHODS: Male C57BL/6J mice were fed a low fat diet (LF), a high-fat diet (HF), or a high-fat containing Doenjang diet (DJ) or a high-fat containing steamed soybean diet (SS) for 11 weeks. RESULTS: Mice fed a DJ diet showed significantly lower body and adipose tissue weights than those in the HF group. Although no significant differences in adipocyte size and number were observed among the HF diet-fed groups, consumption of Doenjang alleviated the incidence of crown-like structures in adipose tissue. Consistently, we observed significantly reduced mRNA levels of oxidative stress markers (heme oxygenase-1 and p40phox), pro-inflammatory adipokines (tumor necrosis factor alpha and macrophage chemoattractant protein-1), macrophage markers (CD68 and CD11c), and a fibrosis marker (transforming growth factor beta 1) by Doenjang consumption. Gene expression of anti-inflammatory adipokine, adiponectin was significantly induced in the DJ group and the SS group compared to the HF group. The anti-oxidative stress and anti-inflammatory effects observed in mice fed an SS diet were not as effective as those in mice fed a DJ diet, suggesting that the bioactive compounds produced during fermentation and aging may be involved in the observed health-beneficial effects of Doenjang. CONCLUSIONS: Doenjang alleviated oxidative stress and restored the dysregulated expression of adipokine genes caused by excess adiposity. Therefore, Doenjang may ameliorate systemic inflammation and oxidative stress in obesity via inhibition of inflammatory signals of adipose tissue.
Adipocytes ; Adipokines ; Adiponectin ; Adipose Tissue* ; Adiposity ; Aging ; Animals ; Diet ; Diet, High-Fat* ; Fermentation ; Fibrosis ; Gene Expression ; Humans ; Incidence ; Inflammation* ; Macrophages ; Male ; Mice* ; Mice, Obese ; Necrosis ; Obesity ; Oxidative Stress* ; RNA, Messenger ; Soybeans* ; Steam ; Weights and Measures

Lymphangioma of the esophagus is a rare submucosal benign tumor. A 49-year-old man was referred because of a foreign body sensation in the esophagus. In endoscopy, a 10.0×1.0-cm longitudinal, translucent, whitish yellow mass covered with normal esophageal mucosa was found in the lower esophagus. Endoscopic ultrasonography revealed a heterogeneous, mainly hypoechoic, well-circumscribed lesion located in the third layer. Incisional biopsy was performed, and histologic findings showed multiple dilated lymphatic vessels, consistent with lymphangioma. After 3 months of proton pump inhibitor treatment, the symptom was relieved and the patient is currently asymptomatic and under surveillance.
Biopsy ; Endoscopy ; Endosonography ; Esophagus ; Foreign Bodies ; Humans ; Lymphangioma ; Lymphatic Vessels ; Middle Aged ; Mucous Membrane ; Proton Pumps ; Sensation

Treatment of choice for early gastric cancer has changed from curative surgery to endoscopic therapy. And the indications for endoscopic treatment of early gastric cancer are expanded. A 70-year-old man was referred for further management of early gastric cancer. In endoscopy, early gastric cancer was suspected at antrum, greater curvature side of gastric body. Endoscopic submucosal dissection was performed. Histology revealed a 6.9×2.7-cm-sized tubular adenocarcinoma, moderately differentiated type and resection margin was negative. Following endoscopy was performed annually. Histology has changed from chronic inflammation to chronic gastritis with intestinal metaplasia, tubular adenoma with low grade dysplasia, tubular adenoma with high grade dysplasia year by year. Laparoscopic subtotal gastrectomy with lymphadenectomy was performed. Histologic finding showed well differentiated tubular adenocarcinoma confined in mucosal layer without lymph node metastasis.
Adenocarcinoma ; Adenoma ; Aged ; Endoscopy ; Gastrectomy ; Gastritis ; Humans ; Inflammation ; Lymph Node Excision ; Lymph Nodes ; Metaplasia ; Neoplasm Metastasis ; Recurrence* ; Stomach Neoplasms*

Colonization of the pre-transplant lung by multidrug-resistant bacteria affects short- and long-term outcomes of lung transplantation. However, there are no case reports on the colonization of a pre-transplant lung by drug-resistant Acinetobacter baumannii. We report a case of extensively drug resistant (XDR) A. baumannii colonization in the tracheobronchial tree that caused severe infectious complications after bilateral lung transplantation. A 23-year-old man diagnosed with bronchiolitis obliterans syndrome (BOS) 4 years earlier with a history of allogenic bone marrow transplantation for acute lymphoblastic leukemia was admitted to the hospital with dyspnea. Due to progressive hypercapnic respiratory failure, long-term mechanical ventilation was started after a tracheostomy was performed, and the patient underwent a bilateral lung transplantation to treat end-stage BOS. After the transplantation, the colonization of XDR A. baumannii caused severe bacterial pneumonia in the early postoperative period. Combined treatment with colistin and meropenem led to recovery from the pneumonia but caused drug-induced renal failure. Because many centers are willing to transplant candidates who are on mechanical ventilation or extracorporeal life support, the incidence of XDR A. baumannii colonization of pretransplant lungs is expected to increase. Further studies are needed to examine pre-transplant management strategies in patients colonized with XDR A. baumannii.
Acinetobacter baumannii ; Bacteria ; Bone Marrow Transplantation ; Bronchiolitis Obliterans ; Colistin ; Colon ; Drug Resistance ; Dyspnea ; Humans ; Incidence ; Lung ; Lung Transplantation ; Pneumonia ; Pneumonia, Bacterial ; Postoperative Period ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Renal Insufficiency ; Respiration, Artificial ; Respiratory Insufficiency ; Tracheostomy ; Young Adult

Emphysematous pyelonephritis (EPN) is a severe gas-forming infection of the renal parenchyma and surrounding tissues. Patients with EPN commonly present with high fever, chills, and flank pain. These symptoms mimic a simple urinary tract infection, such that diagnosis is often delayed. Because of its life-threatening fulminant course, the early detection of EPN and its prompt treatment with intravenous antibiotics with or without percutaneous drainage are critical. Here we describe a case of a 63-year-old Korean female with diabetes mellitus who had no specific symptoms or signs of EPN. A chest computed tomography (CT) scan to assess a right pleural effusion incidentally detected an abnormal gas shadow in the renal parenchyma. An abdominal CT scan performed 5 days later showed increased gas within the kidney parenchyma, but the patient still had no symptoms of EPN. She was treated with intravenous antibiotics alone. A follow-up abdominal CT scan revealed the complete disappearance of the features of EPN.
Anti-Bacterial Agents ; Chills ; Diabetes Mellitus ; Diagnosis ; Drainage ; Female ; Fever ; Flank Pain ; Follow-Up Studies ; Humans ; Kidney ; Middle Aged ; Pleural Effusion ; Pyelonephritis* ; Thorax ; Tomography, X-Ray Computed ; Urinary Tract Infections

Henoch-Schönlein purpura (HSP) is a systemic vasculitis involving the small vessels with distinct clinical features. The etiology of HSP is diverse, and viral infection is one of the many predisposing factors. Cytomegalovirus (CMV) infection mostly affects immune-suppressed patients, but rarely patients with normal immunity can also be affected. Authors experienced a case of HSP patient, with underlying small-cell lung cancer (SCLC) with CMV duodenitis. This is a rare case of HSP diagnosed in SCLC patient with predisposing factor of CMV infection.
Causality ; Cytomegalovirus* ; Duodenitis* ; Humans ; Lung Neoplasms ; Purpura* ; Systemic Vasculitis

No abstract available.
Gastrectomy* ; Hyperhomocysteinemia ; Obesity, Morbid* ; Thrombophilia*