No abstract available.
Burkholderia cepacia* ; Skin*

No abstract available.
Herpes Zoster* ; Urinary Retention*

Pyoderma gangrenosum (PG) is a rare and painful skin disease, frequently associated with underlying systemic conditions, such as inflammatory bowel disease or hematological malignancy. PG is generally classified into 4 types: classic (ulcerative), bullous, pustular, and vegetative. Pustular PG is an uncommon variant of PG that the pustules do not progress to form ulcers. We report a case of pustular PG, which was successfully treated with infliximab and topical tacrolimus, in a 28 year-old Korean man with ulcerative colitis.
Antibodies, Monoclonal ; Colitis, Ulcerative ; Hematologic Neoplasms ; Inflammatory Bowel Diseases ; Pyoderma ; Pyoderma Gangrenosum ; Skin Diseases ; Tacrolimus ; Ulcer ; Infliximab

DRESS syndrome is an uncommon but potentially life-threatening subset of severe drug eruption characterized by fever, rash, leukocytosis with eosinophilia or atypical lymphocytosis, lymphadenopathy, and liver or renal dysfunction. The aromatic anticonvulsants (phenytoin, phenobarbital, carbamazepine) and sulfonamides are the most common cause of DRESS syndrome. Valproic acid, which is a widely used non-aromatic anticonvulsant, rarely causes DRESS syndrome. We report a case of DRESS syndrome in 47-year-old man caused by the use of valproic acid.
Anticonvulsants ; Drug Eruptions ; Eosinophilia ; Exanthema ; Fever ; Humans ; Leukocytosis ; Liver ; Lymphatic Diseases ; Lymphocytosis ; Middle Aged ; Phenobarbital ; Sulfonamides ; Valproic Acid

Syringomas are common benign adnexal tumors, probably of the eccrine origin. They are more common in women and usually found around the eyelids. An exclusively acral site of the lesions is very rare. We present a case of acral syringomas in a 44 year-old woman, involving only the dorsum of the fingers of both hands. It is important to include syringomas in the clinical differential diagnosis of papular lesions of the hands.
Diagnosis, Differential ; Eczema ; Eyelids ; Female ; Fingers ; Hand ; Humans ; Syringoma

Hepatic tuberculosis is usually associated with active pulmonary or miliary tuberculosis. The occurrence of an isolated hepatic mass-forming tuberculosis with no evidence of tuberculosis elsewhere is rare. We report a case of a 31-year-old male with a solitary hepatic granuloma mimicking a mass-forming intrahepatic cholangiocarcinoma. Ultrasonography, computed tomography, magnetic resonance imaging, and positron emission tomography of the abdomen showed a malignant tumor-like lesion. We then conducted endoscopic ultrasonography (EUS) and EUS-guided fine-needle aspiration (EUS-FNA) for confirmation of the hepatic hilar mass, which was found to be a hepatic tuberculosis granuloma as the final diagnosis.
Abdomen ; Adult ; Biopsy, Fine-Needle ; Cholangiocarcinoma ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Endosonography ; Granuloma ; Humans ; Liver Neoplasms ; Magnetic Resonance Imaging ; Male ; Positron-Emission Tomography ; Tuberculosis ; Tuberculosis, Hepatic ; Tuberculosis, Miliary

Hepatic tuberculosis is usually associated with active pulmonary or miliary tuberculosis. The occurrence of an isolated hepatic mass-forming tuberculosis with no evidence of tuberculosis elsewhere is rare. We report a case of a 31-year-old male with a solitary hepatic granuloma mimicking a mass-forming intrahepatic cholangiocarcinoma. Ultrasonography, computed tomography, magnetic resonance imaging, and positron emission tomography of the abdomen showed a malignant tumor-like lesion. We then conducted endoscopic ultrasonography (EUS) and EUS-guided fine-needle aspiration (EUS-FNA) for confirmation of the hepatic hilar mass, which was found to be a hepatic tuberculosis granuloma as the final diagnosis.
Abdomen ; Adult ; Biopsy, Fine-Needle ; Cholangiocarcinoma ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Endosonography ; Granuloma ; Humans ; Liver Neoplasms ; Magnetic Resonance Imaging ; Male ; Positron-Emission Tomography ; Tuberculosis ; Tuberculosis, Hepatic ; Tuberculosis, Miliary

BACKGROUND/AIMS: Pre-existing diabetes mellitus (DM) has been identified as an adverse prognostic variable associated with increased mortality in various cancers. Although DM and hyperglycemia are considered risk factors for pancreatic cancer (PC), antidiabetic treatments for patients with advanced PC have been overlooked. This study aimed to evaluate the impact of hemoglobin A1c (HbA1c) levels on PC survival. METHODS: We retrospectively reviewed the medical records of first-diagnosed patients with advanced PC who were admitted to Konkuk University Medical Center from 2005 to 2011. RESULTS: A total of 127 patients were enrolled, and there were 111 deaths (87.4%) within the 7-year observational period. The most common etiology was disease progression (n=108). DM before PC diagnosis was observed in 65 patients (51.1%), including 28 patients with new-onset DM. The overall median survival times in patients with and without DM were 198 and 263 days, respectively (p=0.091). Survival time according to HbA1c was significantly different between the <7.0% and > or =7.0% groups (362 and 144 days, respectively; p=0.038). In the HbA1c > or =7.0% group, the median overall survival time was 273 days for the metformin group and 145 days for the nonmetformin oral agent group; however, there was no significant difference between the two groups (p=0.058). CONCLUSIONS: A high HbA1c level may be associated with worse survival in patients with advanced PC with DM. Antidiabetic treatment, metformin in particular, was associated with an improved outcome.
Adult ; Aged ; Aged, 80 and over ; Diabetes Complications/*blood/complications/*mortality ; Female ; Hemoglobin A, Glycosylated/*metabolism ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Pancreatic Neoplasms/*blood/complications/*mortality ; Prognosis ; Republic of Korea/epidemiology ; Retrospective Studies

Radio-frequency ablation (RFA) is a curative treatment for hepatocellular carcinoma (HCC). Percutaneous RFA has been shown to be beneficial for patients with small renal cell carcinoma (RCC) lacking indications for resection. We experienced the case of a 53-year-old male who had conditions that suggested HCC, RCC, and alcoholic liver cirrhosis. Abdominal contrast-enhanced computed tomography (CT) and magnetic resonance image showed liver cirrhosis with 2.8 cm ill-defined mass in segment 2 of the liver and 1.9 cm hypervascular mass in the left kidney. These findings were compatible with the double primary cancers of HCC and RCC. Transarterial chemoembolization (TACE) was performed to treat the HCC. After the TACE, a focal lipiodol uptake defect was noticed on a follow up CT images and loco-regional treatment was recommended. Therefore, we performed RFAs to treat HCC and RCC. There was no evidence of recurrence in the follow up image after 1 month.
Carcinoma, Hepatocellular/complications/*diagnosis/therapy ; Carcinoma, Renal Cell/complications/*diagnosis/therapy ; Catheter Ablation ; Humans ; Kidney Neoplasms/complications/*diagnosis/therapy ; Liver Cirrhosis/complications/*diagnosis ; Liver Neoplasms/complications/*diagnosis/therapy ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Tomography, X-Ray Computed

Cytomegalovirus (CMV) infections are usually diagnosed in immunocompromised patients. A 74-year-old male without any significant medical history visited our center because of abdominal pain and diarrhea which began about a month ago. Abdominal computed tomography revealed segmental enhanced bowel wall thickening on jejunum and single-balloon enteroscopy showed multiple geographic shaped ulcerations covered with exudates on proximal jejunum. Biopsy samples taken during endoscopic examination demonstrated necrotic fibrinopurulent tissue debris and benign ulcer. Nested-PCR analysis of CMV DNA from jejunal tissue was positive. The patient was finally diagnosed with CMV jejunitis and was treated by intravenous ganciclovir for 14 days after which, abdominal pain and diarrhea improved. Our case shows that CMV jejunitis can occur in an immunocompetent adult as multiple jejunal ulcers which can be diagnosed using a single-balloon enteroscope.
Aged ; Antiviral Agents/therapeutic use ; Cytomegalovirus/genetics/isolation & purification ; Cytomegalovirus Infections/complications/*diagnosis/drug therapy ; DNA, Viral/analysis ; Endoscopy, Gastrointestinal ; Enteritis/*diagnosis/etiology/virology ; Ganciclovir/therapeutic use ; Humans ; Injections, Intravenous ; Jejunal Diseases/*diagnosis/etiology/virology ; Male ; Polymerase Chain Reaction ; Tomography, X-Ray Computed