Pneumoperitoneum due to Emphysematous Cholecystitis.
The Ewha Medical Journal.2013;36(2):153-155. doi:10.12771/emj.2013.36.2.153
The Ewha Medical Journal
2002 (v1, n1) to Present ISSN: 1671-8925
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The Ewha Medical Journal.2013;36(2):149-152. doi:10.12771/emj.2013.36.2.149
Antiphospholipid antibody syndrome (APS) is characterized by raised levels of antiphospholipid antibodies (aPL), in association with thrombosis, recurrent fetal loss, and thrombocytopenia. Development of APS is related with idiopathic origin, autoimmune disease, malignancy and, on rare occasions, infection. However, in secondary APS combined with bacterial infections, aPL is usually shown with low titer and rarely associated with thrombotic events. A 52-year-old male was admitted due to pneumonia and multiple hepatosplenic abscesses. He had been treated with proper antibiotics, but he presented ascites and sudden variceal bleeding because of portal vein thrombosis. The bleeding was controlled by endoscopic variceal ligation. Acute portal vein thrombosis was successfully managed by low molecular weight heparin and hepatosplenic abscesses were completely resolved by antibiotics. This case suggests that systemic bacterial infection in immunocompetent patients possibly develops into secondary APS.
Abscess ; Anti-Bacterial Agents ; Antibodies, Antiphospholipid ; Antiphospholipid Syndrome* ; Ascites ; Bacterial Infections* ; Esophageal and Gastric Varices* ; Gastrointestinal Hemorrhage* ; Heparin, Low-Molecular-Weight ; Humans ; Ligation ; Male ; Middle Aged ; Pneumonia ; Portal Vein ; Thrombocytopenia ; Venous Thrombosis
Abscess ; Anti-Bacterial Agents ; Antibodies, Antiphospholipid ; Antiphospholipid Syndrome* ; Ascites ; Bacterial Infections* ; Esophageal and Gastric Varices* ; Gastrointestinal Hemorrhage* ; Heparin, Low-Molecular-Weight ; Humans ; Ligation ; Male ; Middle Aged ; Pneumonia ; Portal Vein ; Thrombocytopenia ; Venous Thrombosis
The Ewha Medical Journal.2013;36(2):144-148. doi:10.12771/emj.2013.36.2.144
Amiodarone has been widely used for supraventricular and ventricular arrhythmias and many patients benefit from its effectiveness in treating potentially life-threatening arrhythmias. However, this drug can cause multi-organ toxicity, including amiodarone-induced pulmonary toxicity (APT). Not only does amiodarone have a long half-life but also is lipophilic and therefore can easily accumulate in tissues. Hence, it is difficult to monitor therapeutic levels and side effects, making it difficult to predict toxicities. In this case, we describe multi-organ complications secondary to amiodarone use, especially APT combined with pneumonia with atypical pathogens and pulmonary hemorrhage. The patient reached a high cumulative dose of amiodarone despite a low maintenance dose of amiodarone. This case highlights an unusual presentation of APT with multi-organ toxicity and we review articles regarding the association between the cumulative dose of amiodarone and amiodarone-induced toxicities.
Amiodarone* ; Arrhythmias, Cardiac ; Biopsy, Needle* ; Drug Toxicity* ; Half-Life ; Hemorrhage ; Humans ; Pneumonia ; Respiratory Insufficiency
Amiodarone* ; Arrhythmias, Cardiac ; Biopsy, Needle* ; Drug Toxicity* ; Half-Life ; Hemorrhage ; Humans ; Pneumonia ; Respiratory Insufficiency
The Beginning of Medical Education for Women in Korea: Boguyeogwan.
The Ewha Medical Journal.2015;38(2):59-62. doi:10.12771/emj.2015.38.2.59
The Ewha Medical Journal.2014;37(1):64-67. doi:10.12771/emj.2014.37.1.64
With the aging population, more patients who have undergone previous coronary artery bypass grafting (CABG) are surviving long enough to require subsequent aortic valve replacement (AVR). Conventional redo AVR after prior CABG involves resternotomy, dissection and clamping of the patent bypass graft vessel. Favorable results have been reported for AVR following previous CABG; however, the problems of this procedure includes that injury to the patent bypass grafts can result in catastrophic complications. Increasing patient age and comorbidities may increase operative mortality, less invasive percutaneous aortic valve intervention has advanced. However, because there are no sufficient data comparing transcatheter aortic valve intervention with surgical AVR, currently, the surgical approach should still be consider as the standard of treatment for AVR following previous CABG. We report a patient in whom successful conventional AVR was underwent after previous CABG with patent left internal mammary artery.
Aging ; Aortic Valve Stenosis ; Aortic Valve* ; Comorbidity ; Constriction ; Coronary Artery Bypass* ; Coronary Vessels* ; Heart Valve Prosthesis Implantation ; Humans ; Mammary Arteries* ; Mortality ; Transplants
Aging ; Aortic Valve Stenosis ; Aortic Valve* ; Comorbidity ; Constriction ; Coronary Artery Bypass* ; Coronary Vessels* ; Heart Valve Prosthesis Implantation ; Humans ; Mammary Arteries* ; Mortality ; Transplants
Chelidonium majus-Induced Acute Hepatitis.
The Ewha Medical Journal.2014;37(1):60-63. doi:10.12771/emj.2014.37.1.60
The use of traditional folk remedies is increasing throughout Asia. Chelidonium majus, a popular herbal remedy, is used to treat abdominal pain caused by various gastrointestinal disorders, including gastric ulcer, gastritis, and biliary tract disease, because of its morphine-like effect. We encountered a 62-year-old woman with acute hepatitis, in which C. majus was suspected to be the etiological factor. The patient had taken high dose of C. majus extract for the preceding 60 days. The clinical context and the temporal association between the start of the herbal medicine treatment and her liver injury allowed us to attribute a causative role to C. majus. The diagnosis was confirmed by liver biopsy and the Council for International Organizations of Medical Sciences/Roussel Uclaf Causality Assessment Method (CIOMS/RUCAM) scale. After C. majus was discontinued, the liver function was restored to normal. In conclusion, because the use of phytotherapy is increasing, we wish to raise awareness of the potential adverse effects of C. majus.
Abdominal Pain ; Asia ; Biliary Tract Diseases ; Biopsy ; Chelidonium* ; Diagnosis ; Drug-Induced Liver Injury ; Female ; Gastritis ; Hepatitis* ; Herbal Medicine ; Humans ; Liver ; Medicine, Traditional ; Middle Aged ; Phytotherapy ; Stomach Ulcer
Abdominal Pain ; Asia ; Biliary Tract Diseases ; Biopsy ; Chelidonium* ; Diagnosis ; Drug-Induced Liver Injury ; Female ; Gastritis ; Hepatitis* ; Herbal Medicine ; Humans ; Liver ; Medicine, Traditional ; Middle Aged ; Phytotherapy ; Stomach Ulcer
Coronary Spastic Angina and Life Threatening Arrhythmia despite Nitroglycerine Infusion.
The Ewha Medical Journal.2014;37(1):56-59. doi:10.12771/emj.2014.37.1.56
Variant angina pectoris is characterized by chest symptoms at rest and transient ST elevation on the electrocardiography due to coronary artery spasm. Although most patients with coronary spasm respond well to medical treatment with vasodilators such as calcium channel blockers and nitrates, some patients show intractable attack of coronary vasospasm despite standard medical therapy. We experienced 50-year-old woman with intractable chest pain due to coronary artery spasm, who suffered from ventricular fibrillation despite continuous intravenous nitrate therapy.
Angina Pectoris, Variant ; Arrhythmias, Cardiac* ; Calcium Channel Blockers ; Chest Pain ; Coronary Vasospasm ; Coronary Vessels ; Electrocardiography ; Female ; Humans ; Middle Aged ; Muscle Spasticity* ; Nitrates ; Nitroglycerin* ; Spasm ; Thorax ; Vasodilator Agents ; Ventricular Fibrillation
Angina Pectoris, Variant ; Arrhythmias, Cardiac* ; Calcium Channel Blockers ; Chest Pain ; Coronary Vasospasm ; Coronary Vessels ; Electrocardiography ; Female ; Humans ; Middle Aged ; Muscle Spasticity* ; Nitrates ; Nitroglycerin* ; Spasm ; Thorax ; Vasodilator Agents ; Ventricular Fibrillation
The Ewha Medical Journal.2014;37(1):52-55. doi:10.12771/emj.2014.37.1.52
Amyloidosis is characterized by extracellular deposition of protein fibrils in one or multiple organs. AA amyloidosis is secondarily occurred to be related with chronic infections or inflammatory diseases. We report a 67-year-old man suffered from secondary AA amyloidosis related with chronic Clostridium difficile colitis after repeated total hip replacement surgery. Infection control is the most important treatment of AA amyloidosis secondary to chronic infection. However, the patient's C. difficile colitis was not controlled well, eventually toxic megacolon with sepsis was developed. Consequently, he had to take total colectomy, but he expired with multi-organ failures. We suggested that early surgical procedure might be one option for intractable C. difficile colitis complicated with secondary amyloidosis.
Aged ; Amyloidosis* ; Arthroplasty, Replacement, Hip ; Clostridium difficile* ; Clostridium* ; Colectomy ; Colitis* ; Humans ; Infection Control ; Megacolon, Toxic* ; Sepsis
Aged ; Amyloidosis* ; Arthroplasty, Replacement, Hip ; Clostridium difficile* ; Clostridium* ; Colectomy ; Colitis* ; Humans ; Infection Control ; Megacolon, Toxic* ; Sepsis
The Ewha Medical Journal.2014;37(1):46-51. doi:10.12771/emj.2014.37.1.46
The rearrangement of c-ros oncogene 1 (ROS1) has been recently identified as an important molecular target in non small cell lung cancer (NSCLC). ROS1 rearrangement and epidermal growth factor receptor (EGFR) mutation were mutually exclusive each other in previous studies, and the clinical implication of co-existence of the two genetic alterations has not been determined. We report a case of 46-year-old female never-smoker NSCLC patient whose tumor harbored ROS1 rearrangement and EGFR mutation concomitantly. She had undergone curative surgery for stage IIIA NSCLC, and the recurrence in left pleura and brain occurred at 2 years after the surgery. She received several lines of chemotherapy including docetaxel plus carboplatin, erlotinib, pemetrexed, and gemcitabine. Erlotinib therapy showed a favorable treatment response with progression-free survival of 9.5 months and partial response of tumor on radiologic evaluations. This case represents a successful erlotinib treatment in a NSCLC patient with concurrent ROS1 rearrangement and EGFR mutation.
Adenocarcinoma* ; Brain ; Carboplatin ; Carcinoma, Non-Small-Cell Lung ; Disease-Free Survival ; Drug Therapy ; Female ; Humans ; Lung* ; Middle Aged ; Oncogenes ; Pleura ; Receptor, Epidermal Growth Factor ; Recurrence ; Small Cell Lung Carcinoma ; Erlotinib Hydrochloride ; Pemetrexed
Adenocarcinoma* ; Brain ; Carboplatin ; Carcinoma, Non-Small-Cell Lung ; Disease-Free Survival ; Drug Therapy ; Female ; Humans ; Lung* ; Middle Aged ; Oncogenes ; Pleura ; Receptor, Epidermal Growth Factor ; Recurrence ; Small Cell Lung Carcinoma ; Erlotinib Hydrochloride ; Pemetrexed
Vertebral Artery Dissection Presented with Monoplegia by Cervical Radiculopathy.
The Ewha Medical Journal.2014;37(1):41-45. doi:10.12771/emj.2014.37.1.41
Vertebral artery dissection (VAD) is one of important causes of posterior circulation strokes in young age patients. Typical presentations of VAD are occipital headache or posterior neck pain, with various signs arising from brainstem or cerebellar infarctions. Muscular weakness or sensory change of an ipsilateral arm owing to cervical nerve root involvement in association with the VAD has been reported very rarely. Herein we describe two unusual manifestations of extracranial VAD, which presented with monoplegia of single upper limb.
Arm ; Brain Stem ; Headache ; Hemiplegia* ; Humans ; Infarction ; Muscle Weakness ; Neck Pain ; Radiculopathy* ; Stroke ; Upper Extremity ; Vertebral Artery Dissection* ; Vertebral Artery*
Arm ; Brain Stem ; Headache ; Hemiplegia* ; Humans ; Infarction ; Muscle Weakness ; Neck Pain ; Radiculopathy* ; Stroke ; Upper Extremity ; Vertebral Artery Dissection* ; Vertebral Artery*
Country
Republic of Korea
Publisher
Ewha Womans University School of Medicine
ElectronicLinks
http://synapse.koreamed.org/LinkX.php?code=0201EMJEditor-in-chief
Lee, Ryung-Ah
Abbreviation
Ewha Med J
Vernacular Journal Title
이화의대지
ISSN
2234-3180
EISSN
2234-2591
Year Approved
2013
Current Indexing Status
Currently Indexed
Start Year
1978
Description
The Ewha Medical Journal (Ewha Med J, http://emj.ewhamed.ac.kr), the official publication of Ewha Womans University School of Medicine, is published quarterly a year, last day of April, July, October and January. It covers all fields of medical science including clinical research and basic medical science. The Journal aims to communicate new medical information between medical personnels and to help development of medicine and propagation of medical knowledge.
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