BACKGROUND: Anemia is the most common hematologic condition encountered in outpatient clinics. It is often overlooked because it is common among patients; however, anemia is one of the leading indicators of cancer. This study examined the prevalence and characteristics of cancer among anemia patients who visited an outpatient clinic. METHODS: The data were collected by reviewing the records of an outpatient clinic from January 2007 to December 2011. RESULTS: In total, 502 patients (52 males, 450 females) were diagnosed with anemia. Cancer prevalence among anemia patients was 5.57% (25.0%, men; 3.3%, women); further, the most frequently diagnosed cancer was colorectal cancer (22.5%), followed by advanced gastric cancer (16.1%), breast cancer (9.6%), myelodysplastic syndrome (9.6%), cervical cancer (6.4%), renal-cell carcinoma (6.4%), and thyroid cancer (6.4%). The prevalence of cancer was 4.1% in those aged 40-49 years, 4.2% in the subjects in their fifties, 8.0% in those in their sixties, 21.6% in those in their seventies, and 55.6% in those aged over 80 years. The cancer prevalence among iron deficiency anemia (IDA) patients was 6.18% (28.8%, men; 3.5%, women). The cancer prevalence in postmenopausal and premenopausal female IDA patients was 16.0% and 1.6%, respectively. CONCLUSION: Among anemia patients, male patients aged over 40 years and female patients aged over 60 years, along with postmenopausal female patients, were more likely to be diagnosed with cancer. Consequently, male IDA patients, and female patients aged over 60 years must be carefully evaluated for the possibility of malignancy.
Aged ; Ambulatory Care Facilities ; Anemia ; Anemia, Iron-Deficiency ; Breast Neoplasms ; Colorectal Neoplasms ; Female ; Humans ; Male ; Myelodysplastic Syndromes ; Outpatients ; Prevalence ; Stomach Neoplasms ; Thyroid Neoplasms ; Uterine Cervical Neoplasms

BACKGROUND: Anemia is the most common hematologic condition encountered in outpatient clinics. It is often overlooked because it is common among patients; however, anemia is one of the leading indicators of cancer. This study examined the prevalence and characteristics of cancer among anemia patients who visited an outpatient clinic. METHODS: The data were collected by reviewing the records of an outpatient clinic from January 2007 to December 2011. RESULTS: In total, 502 patients (52 males, 450 females) were diagnosed with anemia. Cancer prevalence among anemia patients was 5.57% (25.0%, men; 3.3%, women); further, the most frequently diagnosed cancer was colorectal cancer (22.5%), followed by advanced gastric cancer (16.1%), breast cancer (9.6%), myelodysplastic syndrome (9.6%), cervical cancer (6.4%), renal-cell carcinoma (6.4%), and thyroid cancer (6.4%). The prevalence of cancer was 4.1% in those aged 40-49 years, 4.2% in the subjects in their fifties, 8.0% in those in their sixties, 21.6% in those in their seventies, and 55.6% in those aged over 80 years. The cancer prevalence among iron deficiency anemia (IDA) patients was 6.18% (28.8%, men; 3.5%, women). The cancer prevalence in postmenopausal and premenopausal female IDA patients was 16.0% and 1.6%, respectively. CONCLUSION: Among anemia patients, male patients aged over 40 years and female patients aged over 60 years, along with postmenopausal female patients, were more likely to be diagnosed with cancer. Consequently, male IDA patients, and female patients aged over 60 years must be carefully evaluated for the possibility of malignancy.
Aged ; Ambulatory Care Facilities ; Anemia ; Anemia, Iron-Deficiency ; Breast Neoplasms ; Colorectal Neoplasms ; Female ; Humans ; Male ; Myelodysplastic Syndromes ; Outpatients ; Prevalence ; Stomach Neoplasms ; Thyroid Neoplasms ; Uterine Cervical Neoplasms

Typhlitis is a necrotizing colitis that usually occurs in neutropenic patients and develops most often in patients with hematologic malignancies such as leukemia and lymphoma. Typhlitis may proceed to bowel perforation, peritonitis and sepsis, which requires immediate treatment. Irinotecan is a semisynthetic analogue of the natural alkaloid camptothecin which prevents DNA from unwinding by inhibition of topoisomerase I. It is mainly used in colon cancer and small cell lung carcinoma (SCLC), of which the most common adverse effects are gastrointestinal toxicities. To the best of our knowledge, no case of typhlitis after chemotherapy with a standard dose of irinotecan in a solid tumor has been reported in the literature. We, herein, report the first case of typhlitis developed after chemotherapy combining irinotecan and cisplatin in a patient with SCLC.
Camptothecin ; Cisplatin ; Colitis ; Colonic Neoplasms ; DNA ; DNA Topoisomerases, Type I ; Hematologic Neoplasms ; Humans ; Leukemia ; Lymphoma ; Peritonitis ; Sepsis ; Small Cell Lung Carcinoma ; Typhlitis

Emphysematous gastritis is an infectious disease in which air is formed in the gastric wall by gas-forming organisms. It is infrequently reported but can be fatal without early diagnosis and treatment. The stomach is rarely infected because of the acidity of the gastric secretions and the rich blood supply. Treatment should be aimed at covering gram-negative organisms and anaerobes using broad-spectrum intravenous antibiotics, and occasional surgical management in order to enhance survival. Risk factors are those that lead to disrupted mucosal integrity, such as corrosive injury, and those that result in an immunosuppressed condition, including diabetes mellitus, chronic kidney disease, immunosuppressive drug use, and subsequent invasion by gas-forming organisms. We experienced a case of emphysematous gastritis that worsened after endoscopy. Aeration during upper endoscopy examination can cause barotrauma to the gastric wall with impairment of the mucosal barrier, resulting in the spread of gastric wall infection to the whole body. Therefore, we report this case and provide relevant literature review to suggest that early endoscopic evaluation can lead to exacerbation of emphysematous gastritis.

Steroid-induced osteoporosis is the most common cause of secondary osteoporosis and accounts for one-fifth of all osteoporosis cases. The fracture incidence under steroid may be as high as 50%. However, many patients do not undergo appropriate risk assessment and treatment before and after steroid exposure. We described a 56-year-old male patient with multiple punched-out lesions in skull unusually as well as vertebral, fibular, rib and humeral fractures during steroid use without proper management.
Humans ; Humeral Fractures ; Incidence ; Male ; Middle Aged ; Osteoporosis ; Ribs ; Risk Assessment ; Skull

In order to identify novel proapoptotic genes, we screened approximately 1,000 hypothetical genes whose functions are completely unknown. After these genes were transiently expressed in HeLa cells, their nuclei images were captured using automated high-speed fluorescence microscope, through which the ratio of apoptotic nuclei was estimated. We selected genes that induce greater than 3-fold increase in apoptotic nuclei compared to that of the vector control. The candidate proapoptotic genes were sequenced and their effects on cell death were further confirmed by the additional assay, DNA fragmentation ELISA. Finally, we were able to identify 4 full-length hypo-thetical genes with proapoptotic activity.
Apoptosis ; Cell Death ; DNA Fragmentation ; Enzyme-Linked Immunosorbent Assay ; Fluorescence ; HeLa Cells ; Humans

The gastric marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) is a rare disease. Helicobacter pylori infection is known as an important etiologic factor of the pathogenesis of MALT lymphoma. H. pylori colonization at the epithelium of gastric mucosa induces T cell and B cell recruitment. T cell induced B cell proliferation develops the MALT in the gastric mucosa. Monoclonal proliferation of B cell in the MALT transform into MALT lymphoma. The eradication of H. pylori is known to induce remission of the disease in more than 80% of patients. But there is no report on progression and development of MALT lymphoma after H. pylori eradication. We experienced two cases of gastric B cell MALT lymphoma diagnosed at long last, after the successful eradication of H. pylori.
Cell Proliferation ; Colon ; Epithelium ; Gastric Mucosa ; Helicobacter ; Helicobacter pylori ; Humans ; Lymphoid Tissue ; Lymphoma, B-Cell, Marginal Zone ; Rare Diseases

The gastric marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) is a rare disease. Helicobacter pylori infection is known as an important etiologic factor of the pathogenesis of MALT lymphoma. H. pylori colonization at the epithelium of gastric mucosa induces T cell and B cell recruitment. T cell induced B cell proliferation develops the MALT in the gastric mucosa. Monoclonal proliferation of B cell in the MALT transform into MALT lymphoma. The eradication of H. pylori is known to induce remission of the disease in more than 80% of patients. But there is no report on progression and development of MALT lymphoma after H. pylori eradication. We experienced two cases of gastric B cell MALT lymphoma diagnosed at long last, after the successful eradication of H. pylori.
Cell Proliferation ; Colon ; Epithelium ; Gastric Mucosa ; Helicobacter ; Helicobacter pylori ; Humans ; Lymphoid Tissue ; Lymphoma, B-Cell, Marginal Zone ; Rare Diseases

Spontaneous rupture of the urinary bladder is a rare clinical entity, with the incidence reported as 1 in 126,000 hospital admissions. It is often associated with malignancy, inflammatory lesions, irradiation, calculus, diverticulum, binge alcohol drinking, continuous bladder irrigation, and neurogenic bladder. In rare instances, bladder rupture occurs without obvious causes. This rare clinical condition is difficult to diagnose because of vague symptoms. High index of suspicion is needed as the mortality rate is high if untreated. A 37-year-old woman with uncontrolled type 2 diabetes, was admitted to the emergency room complaining of progressive abdominal distension and discomfort. She had a past history of tubo-ovarian and bladder abscess, and had undergone multiple surgical operations. From ascites fluid study, she was diagnosed as spontaneous bladder rupture. A transurethral catheter was inserted and the symptoms and signs resolved. Bladder rupture, mimicking acute kidney injury of diabetic nephropathy was disclosed without surgery.
Abscess ; Acute Kidney Injury ; Alcohol Drinking ; Ascites ; Calculi ; Catheters ; Diabetes Mellitus, Type 2 ; Diabetic Nephropathies ; Diverticulum ; Emergencies ; Female ; Humans ; Incidence ; Rupture ; Rupture, Spontaneous ; Urinary Bladder ; Urinary Bladder, Neurogenic

BACKGROUND/AIMS: The aim of this study was to assess the diagnostic use of endoscopic ultrasonograpy (EUS) in detecting the cause of common bile duct (CBD) dilatation in patients in whom abdominal ultrasonography or abdominal CT scan could not identify the cause of dilatation. METHODS: Thirty-seven patients (23 men, 14 women, mean age 62.2 years) with uncertain causes of CBD dilatation on abdominal sonogram and CT scan between October 1999 and November 2003 were enrolled. All patients were evaluated by EUS and endoscopic retrograde cholangiopancreatography (ERCP). Final diagnosis were determined by ERCP, surgical exploration and clinical follow-up. RESULTS: The following diagnosis were made by EUS: choledocholithiasis in 11 patients, CBD dilatation only in 12, benign stricture of distal CBD in 8, periampullary tumor in 6. The definitive diagnosis of choledocholithiasis (n=11), benign stricture of distal CBD (n=10), ampullary tumor (n= 5) were determined by ERCP with or without sphincterotomy and surgical exploration. EUS provided the accurate explanation for CBD dilatation in 32 of the 37 patients (86%). CONCLUSIONS: When the diagnosis of biliary obstruction remains obscure on abdominal sonography or CT scan, EUS may be useful.
Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis ; Common Bile Duct* ; Constriction, Pathologic ; Diagnosis ; Dilatation* ; Endosonography* ; Female ; Follow-Up Studies ; Humans ; Male ; Tomography, X-Ray Computed ; Ultrasonography