This is a report of gastric metastases secondary from a primary small cell carcinoma of the lung in two men. Blood-borne metastatic involvement of the stomach by cancer is a rare entity. According to the reports in the literature the prevalence of metastasis to the stomach occurs in 0.4% and the most common cell type of the primary lung carcinoma is large cell type(3.7%) followed by adenocarcinoma(2.4%), small cell carcinoma(1.7%) and squamous cell carcinoma(0.7%). The most common tumors that spread to the stomach through the blood stream are malignant melanoma, breast carcinoma and lung carcinoma. Most of the gastrointestinal tract metastases had no specific symptoms because of its submucosal involvement. The prognosis was poor and the mean survival period from the onset of symptoms was 49 days. The first patient was a 56-year-old man who had primary lung carcinoma with brain metastasis. Gastroscopic findings showed two elevated mass lesions in the anterior wall of the mid body with central ulcer and the posterior wall of the fundus with intact surface mucosa. Pathologic examination of stomach tissue revealed small cell type tumor cells infiltrate in the stomach wall segmentally without destruction of the glands. The second patient was a 67-year-old man who had no other evidence of the distant metastasis. Gastroscopic findings showed a huge, oval shaped, ulcerofungating mass with deep penetrating central ulcer coated with dirty exudate in the anterior wall from mid to upper body of the stomach, and thickened elevated rugal folds in the posterior wall of the fundus. Pathologic examination of stomach tissues revealed the small cell type tumor cells showing small smudged nucleus infiltrate into the mucosa of the stomach and the architecture of mucosa intact. We report the two cases of metastatic gastric cancer from the primary small cell lung carcinoma with the literature review.
Background: Pulmonary tuberculosis (TB), requiring the intensive care unit (ICU) care, has been a high-mortality condition until now. In the present study, we aimed to investigate clinical features and parameters associated with TB mortality. Methods: From August 2003 to December 2008, patients with microbiologically or histologically confirmed pulmonary TB then admitted to the ICU, were retrospectively enrolled into the study. Upon enrollment, their medical records were reviewed. Results: Forty three patients (30 males, 13 females) were included and their mean age was 63.8 years (range: 17~87 years). Twelve patients died, an overall in-hospital mortality of 27.8%. The main reason for the ICU care was dyspnea or hypoxemia requiring mechanical ventilation (n=17). Other diagnoses for ICU care were hemoptysis, monitoring after procedures, neurologic dysfunction, shock, and gastrointestinal bleeding. On univariate analysis, the factors affecting the mortality were malnutrition-related parameters including low body mass index, hypoalbuminemia, lymphocytopenia, and hypocholersterolemia, as well as severity-related variables such as high acute physiology and chronic health evaluation (APACHE) score, number of involved lobes, and high C-reactive protein. In addition, respiratory failure requiring mechanical ventilation and acute respiratory distress syndrome contributed to patient fatality. It was shown on multivariate analysis that respiratory failure and hypoalbuminemia were significantly independent variables associated with the mortality. Conclusion: Acute respiratory failure is the most common reason for the ICU care and also the most important factor in predicting poor outcome. In addition, our data suggest that the parameters associated with malnutrition could be possible factors contributing to mortality.
The microsurgical reconstruction is necessary for elderly patients to treat severe trauma and head and neck tumor. The aim of this study is to analyze the risks of microvascular surgery and whether or not happening of more complication in elderly patients who are older than 60 years old and to suggest the solution of the complication. The retrospective study included 41 elderly patients who underwent treatment of 44 microsurgical reconstructions among total 271 cases of microsurgical reconstruction from July, 1988 to December, 1998. Their ages ranged from 61 years to 79 years. There were 26 males and 15 females. The involved sites were 23 head and necks, 13 upper gastrointestinal tracts, 3 lower extremities, 1 chest and 1 sacral region. The causes of microsurgical reconstruction were 36 head and neck tumors, 2 radionecrosis, 2 traumas and 1 melanoma in lower limb. The used flaps were 14 radial forearm flaps, 13 jejunal flaps, 10 latissimus dorsi muscle flaps, 3 rectus abdominis muscle flaps, 2 lateral arm flaps, 1 scapular flap, and 1 iliac osteocutaneous flap. They had medical problems which were 29 tobacco abuse, 14 hypertensions, 13 alcohol abuse, 10 chronic obstructive pulmonary diseases, 7 diabetes mellituses, 3 ischemic heart diseases. All patients have had successful results without specific complications except 3 cases of free flap failure and 3 perioperative death. The causes of 3 flap failures were 2 flap necrosis due to arterial insufficiency and 1 flap loss due to secondary infection. All of these cases were treated with secondary free flap surgery. However 3 patients died perioperatively due to 2 respiratory arrests and 1 sepsis. It was not related to operate microsurgical reconstruction itself, but was correlated with the complication of postoperative care after head and neck surgery. We conclude that plastic surgeons consider the importance of prevention of expected complication as thorough analysis of operative risk factor and appropriate treatment. We had to select the donor and recipient vessel appropriately to perform successful microsurgery in elderly patients and consider vein graft and end-to-side anastomosis to reduce complication if necessary. In addition, we emphasize the importance of pre, peri and postoperative care in head and neck cancer patients to reduce postoperative complication and morbidity.
Cho, Joon Hyun;Jung, Jong Pil;Cha, Hee Jeong;Park, Chang Ryul;Kim, Sung Ryul;Kim, Hawk;Park, Jin Woo;Woo, Soon Joo;Eum, Eun A;Lee, Ki Young;Jegal, Yang Jin
Tuberculosis and Respiratory Diseases
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v.61
no.2
/
pp.171-177
/
2006
Extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT lymphoma) is usually indolent. Although it was reported recently that about 20-30% cases of MALT lymphoma presented with a disseminated disease at diagnosis, it was described as a disease localized at diagnosis and remaining stable for a prolonged period. However, only a few cases of MALT lymphoma involved the lung and gastrointestinal tract all at once. We report a case of a 73-year-old man with disseminated MALT lymphoma. He presented with non-productive cough, initial chest radiograph showed a nodule in the right lower lobe. The diagnosis of stage IV MALT lymphoma was made by CT scan, video-assisted thoracoscopic excisional biopy, gastrofiberscopic biopsy and bone marrow biopsy. The lymphoma involved the lung, stomach and bone marrow at the time of diagnosis. Because he refused chemotherapy, he discharged after Helicobacter pylori eradication without chemotherapy. Regular follow-up examination did not show any evidence of disease progression over 22 months.
Arsenic trioxide($As_2O_3$) was introduced into the treatment of refractory or relapsed acute promyelocytic Ieukemia. Some investigators have reported that arsenic trioxide had induced apoptosis in a variety of solid human tumor cell lines, including non-small cell lung cancer. Non-steroidal anti-inflammatory drugs(NSAIDs) are powerful chemopreventive agents for gastrointestinal cancers and the growth of established tumors are reduced by inducing apoptosis. It's also reported that NSAIDs enhanced tumor response to chemotherapeutic drugs or radiation. In this study, we aimed to determine whether combination of arsenic trioxide with sulindac augmented its apoptotic potential in NCI-H157 human lung cancer cells. The human lung cancer cell line NCI-H157 was treated with arsenic trioxide and sulindac. Cell viability was measured by the MTT assay. Apoptosis was measured by nuclear staining and flow cytometric analysis. The catalytic activity of the caspase families were measured by the fluorogenic cleavage of biosubstrates. The western blotting were also performed to define the mechanical basis of apoptosis. Combination treatment of arsenic trioxide and sulindac decreased the viability of NCI-H157 human lung cancer cells in a dose-dependent manner. The catalytic activity of caspase-3, 8 and 9 proteases were increased after combination treatment. Consistently PARP was cleaved from 116kDa to 85kDa fragments, and the expression of ICAD was decreased by time-dependent manner. Also combination treatment increased the expression of Fas and Fas/L. Combination therapy of arsenic trioxide with sulindac augments cell death and induces apoptosis via the activation of caspase cascade in NCI-H157 human lung carcinoma cells.
Chang, Bo Yoon;Han, Ji Hye;Cha, Bum-Suk;Ann, Sung-Ho;Kim, Sung Yeon
Journal of Food Hygiene and Safety
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v.30
no.3
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pp.295-301
/
2015
The functions of probiotics, particularly Lactic acid bacteria, have been studied in a range of human diseases, including cancer, infectious diseases, gastrointestinal disorders, and allergies. Among the many benefits associated with the consumption of probiotics, modulation of immune activity has received the most attention. This study aimed at investigating the improved immune stimulatory and stability of L. plantarum when cultivated on modified basal media supplemented with the Undaria pinnatifida co-cultured with L. plantarum. An in vitro test showed that U. pinnatifida media cultured L. plantarum is strong enough to survive in the gastric juice (gastric and bile acid). Mouse macrophage-derived cell lines RAW 264.7 was used to measured immune stimulating activity of L. plantarum. When U. pinnatifida media cultured by L. plantarum was NO and $TNF-{\alpha}$ production is significantly increased compared to basal media cultured L. plantarum. These results show that U. pinnatifida could be applied for a component for cultivation of L. plantarum. This optimized U. pinnatifida medium can be used the improving of stability and immune function on production of probiotics.
Cho, Yun-jae;Lee, Hanul;Jeong, Hae In;Lee, Hyun-Jin;Keum, Chang-Yul;Han, Aram;Ha, Na-Yeon;Kim, Jinsung
The Journal of Internal Korean Medicine
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v.42
no.4
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pp.488-509
/
2021
Purpose: Functional dyspepsia (FD) is a chronic syndrome accompanied by repetitive digestive symptoms that appear in the upper gastrointestinal tract and are not caused by specific diseases. Psychological symptoms like anxiety, depression, insomnia, and somatization are frequently observed in FD. The purpose of this study was to review the effect of herbal medicine on the psychological symptoms that accompany FD. Methods: Database search (PubMed, EMBASE, KISS, Kmbase, KoreanMed, NDSL, OASIS, CNKI) was performed on February 24, 2021; a total of 1825 studies were searched. After the screening, 22 studies were included. Results: The studies were assessed by Cochrane RoB 2 and sorted into a table according to psychological symptoms. Meta-analysis was performed to estimate the effect of herbal medicine. Twenty of the twenty-two studies reported that herbal medicine was significantly more effective than the control group. Only three of the studies did not have a high risk of bias. Conclusion: Herbal medicine was significantly effective with or without Western medicine and had fewer adverse effects. Severe adverse effect was not reported. Psychological symptoms in FD affect onset and duration of FD, and some FD patients want to be treated for their anxiety before other symptoms. Reliable information about treatment for the psychological symptoms of FD is lacking. We reviewed the effect of herbal medicine treatment in this study, the results of which could be selected for primary or secondary treatment for FD.
Kwak, Shinhyeung;Kim, Dongsub;Choi, Joon-sik;Yoon, Yoonsun;Kim, Eun Sil;Kim, Mi Jin;Yoo, So-Young;Shim, Jong Sup;Choe, Yon Ho;Kim, Yae-Jean
Pediatric Infection and Vaccine
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v.29
no.2
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pp.96-104
/
2022
Chronic recurrent multifocal osteomyelitis (CRMO) is an inflammatory bone disorder presenting with sterile osteomyelitis, most often presenting in childhood. Although the etiology is understood incompletely, its association with other auto-inflammatory diseases including inflammatory bowel disease (IBD); psoriasis; Wegener's disease; arthritis; and synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome suggests that dysregulated innate immunity may play an important role in the pathogenesis. We report a case of a 13-year-old boy with CRMO associated with Crohn's disease (CD) successfully treated with infliximab after failure of non-steroidal anti-inflammatory drug (NSAID) treatment. He initially was diagnosed with CRMO based on symmetric and aseptic bone lesions with no fever, lack of response to antibiotic treatment, vertebral involvement, and normal blood cell counts. Despite five months of NSAID treatment, his musculoskeletal symptoms were aggravated, and he developed gastrointestinal symptoms. Finally, he was diagnosed with CRMO associated with CD. Due to the severity of symptoms, infliximab was initiated and produced symptom improvement. This case supports infliximab as another choice for treatment of bowel symptoms in addition to the bone and joint symptoms of CRMO when other first-line treatments are ineffective.
The object of this study is to measure the transit time and passage rate of capsule endoscopy (CE) in the gastrointestinal tract in medium sized beagle dogs ($7{\sim}13\;kg$). Animals were divided into four groups: only capsule (group 1, n=10), capsule+water (group 2, n=10), mettoclopramide+capsule (group 3, n=10), metoclopramide +capsule+water (group 4, n=10). The capsule transit times through the stomach and small bowel were evaluated by radiography findings. Gastric transit time (GTT), small intestinal transit time (SITT) and complete passage rate were measured in four groups. GTT's for each group were as follows; $45{\pm}20\;min$ (group 1), $117{\pm}35\;min$ (group 2), $150{\pm}40\;min$ (group 3), and $154{\pm}65\;min$ (group 4), while SITT's were $75{\pm}20\;min$ (group 1), $195{\pm}55\;min$ (group 2), $70{\pm}15\;min$ (group 3), and $76{\pm}15\;min$ (group 4). The complete passage rates were 20% (group 1), 40% (group 2), 20% (group 3), 50% (group 4). In all groups, if CE could pass through the pylorus, it passed all small intestinal tracts within 8 hours (battery life). Administration of water helped CE to pass pylori, except in case of metoclopramide administration. These results indicate that CE could be an useful tool for examining gastrointestinal diseases in the veterinary medicine.
Park, Seung-Kyu;Lee, Sang-Yeol;Ryu, Han-Seung;Choi, Suck-Chei;Yang, Chan-Mo;Jang, Seung-Ho;Yeom, Dong Han;Lee, Kuy-Haeng
Korean Journal of Psychosomatic Medicine
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v.29
no.1
/
pp.58-66
/
2021
Objectives : The purpose of this study is to compare the psychosocial characteristics of patients diagnosed with functional gastrointestinal disorder (FGID) by classifying them into irritable bowel syndrome (IBS), functional dyspepsia (FD), functional constipation (FC), functional heartburn (FH) groups, and overlap group (two or more functional diseases) and to examine the factors associated with the quality of life (QoL) of patients with FGID. Methods : A total of 144 patients who were diagnosed with FGID were selected as the subjects. The demographical factors were investigated; Korean-Beck Depression Inventory-II (K-BDI-II), Korean-Beck Anxiety Inventory (K-BAI), Korean version of Childhood Trauma Questionnaire (K-CTQ), Multi-dimensional Scale of Perceived Social Support (MSPSS), Korean Version of Connor-Davidson Resilience Scale (K-CD-RISC), and World Health Organization Quality of Life Assessment Instrument Brief Form (WHOQOL-BREF) were used to evaluate the psychosocial factors. Results : TThe overlap group had a significantly higher K-BDI-II score (F=11.09, p<0.001) and K-BAI score (F=8.93, p<0.001) compared to other groups. In childhood trauma, the IBS patients had a difference in emotional neglect (F=2.54, p=0.04) than the FD patients. The QoL of FGID patients had a negative correlation with depression (r=-0.196, p<0.01), anxiety (r=-0.235, p<0.01), and childhood trauma (r=-0.222, p<0.01), and a positive correlation with social support (r=0.512, p<0.01) and resilience (r=0.581, p<0.01). Conclusions : Overlap group had a higher level of depression and anxiety, and the IBS patient group had a higher level of emotional neglect than the FD patient group in terms of childhood trauma.
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