Hepatoid adenocarcinoma is a rare variant of adenocarcinoma that can occur in the stomach. This neoplasm has a poor prognosis and it frequently presents at an advanced stage of disease; it is clinically characterized by increased serum levels of alpha-fetoprotein (AFP) in most cases. We experienced a case of hepatoid adenocarcinoma of the stomach with multiple liver metastases that mimicked germ cell tumor in a 43-year-old man. He had incidentally detected gastric adenocarcinoma via gastrofibroscopy and he underwent subtotal gastrectomy. The postoperative pathologic stage was II (T2N1M0). He complained of epigastric pain. The serum AFP was markedly increased (227,325 IU/mL) and abdominal CT revealed multiple liver masses. We considered these as extragonadal germ cell tumors that occurred in the liver because of the markedly elevated AFP, the short duration of follow-up and early stage of stomach cancer at the that time. To confirm the diagnosis, biopsy of liver mass was done and he was diagnosed with hepatoid adenocarcinoma.
Adenocarcinoma* ; Adult ; alpha-Fetoproteins ; Biopsy ; Diagnosis ; Follow-Up Studies ; Gastrectomy ; Germ Cells* ; Humans ; Liver ; Neoplasm Metastasis ; Neoplasms, Germ Cell and Embryonal* ; Prognosis ; Stomach ; Stomach Neoplasms ; Tomography, X-Ray Computed

All-trans retinoic acid (ATRA) is a potent differentiating agent for the treatment of acute promyelocytic leukemia (APL). Although ATRA is generally well-tolerated, some patients develop side effects, the most severe of which is ATRA syndrome. We report on a patient with APL who developed isolated nephrotic-range proteinuria during ATRA therapy for remission-induction. ATRA was discontinued and the proteinuria decreased significantly 5 days after dexamethasone treatment. The occurrence of isolated proteinuria during ATRA treatment is a rare adverse event.
Dexamethasone ; Humans ; Leukemia, Promyelocytic, Acute ; Proteinuria ; Tretinoin

Dermatomyositis is an autoimmune disease wherein autoantibodies and immune complexes cause non-suppurative inflammation in skin and muscle. Although the skin lesions of this disease are well known, the clinical and pathological features of subcutaneous fat lesions remain uncharacterized. Since Weber (1924) reported the development of panniculitis in a patient with dermatomyositis, 23 subsequent cases have been reported. Here, we present the case of a woman who had been diagnosed with dermatomyositis 7 years previously, and presented with diffuse, painful, indurated nodules on her face and upper limbs. A skin biopsy allowed us to diagnose these nodules as panniculitis. The patient was initially treated with high doses of prednisolone and methotrexate. She responded inadequately to these medications, so azathioprine was added to the regimen. The skin lesions subsequently improved and the patient has remained disease-free for 1 year. Here, we present the clinical profile of this patient and review the relevant literature.
Antigen-Antibody Complex ; Autoantibodies ; Autoimmune Diseases ; Azathioprine ; Biopsy ; Dermatomyositis ; Female ; Humans ; Inflammation ; Methotrexate ; Muscles ; Panniculitis ; Prednisolone ; Skin ; Subcutaneous Fat ; Upper Extremity

Paraneoplastic cancer polyarthritis is a very rare manifestation of musculoskeletal disorders associated with several solid and hematologic malignancies. We describe a 71-year-old woman who presented initially with an abrupt onset of rheumatoid arthritis-like symmetrical polyarthritis. The patient was diagnosed with pancreatic cancer with multiple hepatic metastases approximately six months later. Her symptoms of polyarthritis improved after the introduction of medication including non-steroidal anti-inflammatory drugs and disease modifying anti-rheumatic drugs. This case suggests that a hidden malignancy should always be considered in elderly patients, who present with an abrupt onset of symmetric polyarthritis for the first time in their life.
Aged ; Antirheumatic Agents ; Arthritis ; Arthritis, Rheumatoid ; Female ; Hematologic Neoplasms ; Humans ; Neoplasm Metastasis ; Pancreatic Neoplasms ; Paraneoplastic Syndromes

Turner's syndrome (TS) is characterized by short stature and gonadal dysgenesis. It is often associated with systemic manifestations, such as cardiovascular, gastrointestinal, and musculoskeletal disorders. Although very rare, it is possible for TS to accompany autoimmune disease, including thyroid disease, inflammatory bowel diseases, diabetes mellitus, psoriatic arthritis, and juvenile rheumatoid arthritis. A 39-year-old woman was referred for symmetric polyarthritis of her hands and feet. She had been diagnosed with Turner's syndrome with 46,XO,-X,+fragment before the age of 22 years and had developed autoimmune hypothyroidism treated with thyroid hormone replacement. At the time of first visit, she had polyarthralgia with morning stiffness for more than 3 months. The musculoskeletal examination revealed symmetrical polyarthritis affecting the metacarpophalangeal, proximal interphalangeal, and metatarsophalangeal joints, fulfilling the ACR 1987 revised criteria for rheumatoid arthritis (RA). Here, we present an unusual case of RA associated with TS. It is important to pay meticulous attention to patients with TS so that inflammatory arthritis is not neglected and the diagnosis is not delayed.
Adult ; Arthralgia ; Arthritis ; Arthritis, Juvenile Rheumatoid ; Arthritis, Psoriatic ; Arthritis, Rheumatoid ; Autoimmune Diseases ; Diabetes Mellitus ; Female ; Foot ; Gonadal Dysgenesis ; Hand ; Humans ; Hypothyroidism ; Inflammatory Bowel Diseases ; Metatarsophalangeal Joint ; Thyroid Diseases ; Thyroid Gland ; Turner Syndrome

PURPOSE: The aim of this study was to explore the nursing needs and satisfaction of pediatric cancer patient families during chemotherapy. METHODS: Data collection was conducted from April to July 2016 using the questionnaire of nursing needs and satisfaction developed by the researchers in 123 families of children who were diagnosed with pediatric cancer and undergoing chemotherapy. The collected data were analyzed by descriptive statistics, t-test, and ANCOVA using the SPSS 22.0 program. RESULTS: Nursing needs and satisfaction were 4.27 ± 0.78 and 4.16 ± 0.57, respectively. Significant differences between nursing need and satisfaction were observed in the educational/informational domain (t=3.94, p=<.001) and community resources nursing domain (t=2.16, p=.032). Also, in terms of general characteristics, the nursing needs were significantly different depending on the elapsed time after diagnosis (t=1.98, p=.049), and the nursing satisfaction was significantly different depending on the type of treatment (F=4.02, p=.009). CONCLUSION: Based on the results of this study, when caring for children who are receiving chemotherapy and their family, it is necessary to develop nursing interventions that meet the individualized nursing needs of those directly and indirectly affected.
Antineoplastic Agents ; Child ; Data Collection ; Diagnosis ; Drug Therapy* ; Humans ; Needs Assessment ; Nursing* ; Pediatric Nursing ; Personal Satisfaction

Brucellosis is an endemic zoonotic disease, particularly in the Middle East and Mediterranean regions, and can involve many organs and tissues. Recently, the incidence of human brucellosis has increased rapidly in Korea. Brucellosis may often appear as other infections and asymptomatic conditions because of its range of clinical manifestations. Therefore, its diagnosis is frequently missed or delayed. Early diagnosis of brucellar spondylitis is important for reducing the number and intensity of complications. Therefore, it should be included in a differential diagnosis of back pain with an unknown origin. Brucellosis is normally transmitted to humans by direct contact with infected animals or by the ingestion of unpasteurized dairy products. We report an unusual case of brucellar spondylitis complicated by acupuncture.
Acupuncture ; Animals ; Asymptomatic Diseases ; Back Pain ; Brucellosis ; Dairy Products ; Diagnosis, Differential ; Early Diagnosis ; Eating ; Humans ; Incidence ; Korea ; Mediterranean Region ; Middle East ; Spondylitis

PURPOSE: To evaluate current feeding practices and maternal nutritional knowledge on complementary feeding. METHODS: Mothers of babies aged 9-15 months who visited pediatric clinics of 14 general hospitals between September and December 2008 were asked to fill questionnaires. Data from 1,078 questionnaires were analyzed. RESULTS: Complementary food was introduced at 4-7 months in 89% of babies. Home-made rice gruel was the first complementary food in 93% cases. Spoons were used for initial feeding in 97% cases. At 6-7 months, <50% of babies were fed meat (beef, 43%). Less than 12-month-old babies were fed salty foods such as salted laver (35%) or bean-paste soup (51%) and cow's milk (11%). The following were the maternal sources of information on complementary feeding: books/magazines (58%), friends (30%), internet web sites (29%), relatives (14%), and hospitals (4%). Compared to the 1993 survey, the incidence of complementary food introduction before 4 months (0.4% vs. 21%) and initial use of commercial food (7% vs. 39%) had decreased. Moreover, spoons were increasingly used for initial feeding (97% vs. 57%). The average maternal nutritional knowledge score was 7.5/10. Less percentage of mothers agreed with the following suggestions: bottle formula weaning before 15-18 months (68%), no commercial baby drinks as complementary food (67%), considering formula (or cow's milk) better than soy milk (65%), and feeding minced meat from 6-7 months (57%). CONCLUSION: Complementary feeding practices have considerably improved since the last decade. Pediatricians should advise timely introduction of appropriate complementary foods and monitor diverse information sources on complementary feeding.
Aged ; Friends ; Hospitals, General ; Humans ; Incidence ; Infant ; Infant Nutritional Physiological Phenomena ; Internet ; Korea ; Meat ; Milk ; Mothers ; Organothiophosphorus Compounds ; Surveys and Questionnaires ; Soy Milk ; Weaning

Yerba Mate, derived from the leaves of the tree, Ilex paraguariensis, is widely-used as a tea or as an ingredient in formulated foods. The aim of the present study was to evaluate the effects of Yerba Mate extract on weight loss, obesity-related biochemical parameters, and diabetes in high-fat diet-fed mice. To this end, by using in vivo animal models of dietary-induced obesity, we have made the interesting observations that Yerba Mate has the ability to decrease the differentiation of pre-adipocytes and to reduce the accumulation of lipids in adipocytes, both of which contribute to a lower growth rate of adipose tissue, lower body weight gain, and obesity. Our data from in vivo studies revealed that Yerba Mate treatment affects food intake, resulting in higher energy expenditure, likely as a result of higher basal metabolism in Yerba Mate-treated mice. Furthermore, in vivo effects of Yerba Mate on lipid metabolism included reductions in serum cholesterol, serum triglycerides, and glucose concentrations in mice that were fed a high fat diet. In conclusion, Yerba Mate can potentially be used to treat obesity and diabetes.
Adipocytes ; Adipose Tissue ; Animals ; Basal Metabolism ; Body Weight ; Cholesterol ; Diet, High-Fat ; Eating ; Energy Metabolism ; Food, Formulated ; Glucose ; Ilex paraguariensis ; Lipid Metabolism ; Mice ; Models, Animal ; Obesity ; Tea ; Trees ; Triglycerides ; Weight Loss