• Title/Summary/Keyword: Tuberculosis, gastrointestinal

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Gastric Tuberculosis Presenting as a Subepithelial Mass: A Rare Cause of Gastrointestinal Bleeding (위장관 출혈을 일으킨 상피하 종양으로 나타난 위 결핵)

  • Kim, Tae Un;Kim, Su Jin;Ryu, Hwaseong;Kim, Jin Hyeok;Jeong, Hee Seok;Roh, Jieun;Yeom, Jeong A;Park, Byung Soo;Kim, Dong Il;Kim, Ki Hyun
    • The Korean Journal of Gastroenterology
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    • v.72 no.6
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    • pp.304-307
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    • 2018
  • Gastric tuberculosis accounts for approximately 2% of all cases of gastrointestinal tuberculosis. Diagnosis of gastric tuberculosis is challenging because it can present with various clinical, endoscopic, and radiologic features. Tuberculosis manifesting as a gastric subepithelial tumor is exceedingly rare; only several dozen cases have been reported. A 30-year-old male visited emergency room of our hospital with hematemesis and melena. Abdominal CT revealed a 2.5 cm mass in the gastric antrum, and endoscopy revealed a subepithelial mass with a visible vessel at its center on gastric antrum. Primary gastric tuberculosis was diagnosed by surgical wedge resection. We report a rare case of gastric tuberculosis mimicking a subepithelial tumor with acute gastric ulcer bleeding.

Solitary Jejunal Tuberculosis with Intestinal Obstruction in an Immunocompetent Patient (면역 능력이 있는 성인에서의 장폐색을 동반한 단일 공장 결핵 1예)

  • Bae, Hyun Jin;Park, Jong Ho;Jin, Su Sin;Jung, Jiyun;Nam, Yun Jung;Kim, Da Won
    • The Korean Journal of Medicine
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    • v.93 no.6
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    • pp.556-559
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    • 2018
  • Intestinal tuberculosis is an infection of the gastrointestinal tract by the Mycobacterium tuberculosis complex. To the best of our knowledge, solitary intestinal tuberculosis accompanied by intestinal obstruction, particularly in the middle of the small intestine, is extremely rare. We report a case of solitary jejunal tuberculosis in a 49-year-old man with no underlying disease. He was admitted a few days after the onset of diffuse abdominal discomfort. Upon evaluation, we initially considered a malignancy of the distal jejunum with ileus due to the presence of a mass. Therefore, he underwent laparoscopic resection of the small bowel. Unexpectedly, the histologic specimen showed a chronic caseating granulomatous lesion with acid-fast bacilli. Ultimately, he was diagnosed with solitary jejunal tuberculosis. He was successfully treated with anti-tuberculosis drugs without any complications.

Gastric Cancer and Concomitant Gastric Tuberculosis: A Case Report

  • Kang, Hyok-Jo;Lee, Young-Seok;Jang, You-Jin;Mok, Young-Jae
    • Journal of Gastric Cancer
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    • v.12 no.4
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    • pp.254-257
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    • 2012
  • Gastric tuberculosis is rare even in the endemic areas of tuberculosis, and can mimic neoplasm by causing elevation of the mucosa with or without ulceration. Here, we report a case in which a 54-year-old female patient admitted for resection of early gastric cancer was found to have coexisting histopathologically and bacteriologically confirmed gastric cancer and tuberculosis.

Intralobar Pulmonary Sequestration Showing Increased Serum CA19-9

  • Ahn, Yong-Hwan;Song, Mi-Jin;Park, Sang-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.6
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    • pp.507-510
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    • 2012
  • Carbohydrate antigen 19-9 (CA19-9) is a specific tumor marker of the biliary, pancreatic and gastrointestinal tracts. CA19-9 is occasionally elevated in serum in patiens with benign pulmonary diseases such as bronchiectasis, idiopathic interstitial pneumonia or collagen disease-associated pulmonary fibrosis. Intralobar pulmonary sequestration is an uncommon congenital lung anomaly. It is dissociated from the normal tracheobronchial tree and is supplied by an anomalous systemic artery. There have been some reports of elevation of CA19-9 in this lesion. We report a case of intralobar pulmonary sequestration with elevated serum CA19-9 in a 29-year-old man who was diagnosed with bronchiectasia of left lower lung field on general check up. He had no evidence of any malignant disease in pancreatobiliary or gastrointestinal tracts. Elevated serum CA19-9 level might be encountered with benign pulmonary disease such as pulmonary sequestration.

A Historical Study on Cho Heon-yeong's 『Eastern Medicine Series (東洋醫學叢書)』 (조헌영의 『동양의학총서(東洋醫學叢書)』에 대한 의사학적 연구)

  • KIM Do-won;CHA Wung-seok
    • The Journal of Korean Medical History
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    • v.35 no.1
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    • pp.119-134
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    • 2022
  • This study is about Cho Heon-yeong's 『Eastern Medicine Series (東洋醫學叢書)』. It consists of 5 clinical books, 『Therapy for People (民衆醫術理療法)』, 『Tuberculosis Eastern Medical Treatment (肺病漢方治療法)』, 『Neurasthenia Treatment (神經衰弱症治療法)』, 『Gastrointestinal Disease Treatment (胃腸病治療法)』 and 『Gynecological Treatment (婦人病治療法)』, which were published between 1935-1941. This series mainly succeeded 『Donguibogam (東醫寶鑑)』, and was influenced by 『Kyeongakjeonseo (景岳全書)』, and 『Hwangjenegyeong (黃帝內經)』. Cho Heon-yeong's medical philosophy appears in two ways. First, he emphasized invigoration in treatment for the people who lacked nutrition and medical care at the time. Second, eclecticism of Korean Medicine and Western medicine is specifically revealed through this series. He aimed for a comprehensive medicine that consists mainly of Korean medicine and includes only a part of Western medicine.

Gender Differences in Clinical Presentations of Cystic Fibrosis Patients in Azeri Turkish Population

  • Vahedi, Leila;Jabarpoor-Bonyadi, Morteza;Ghojazadeh, Morteza;Vahedi, Amir;Rafeey, Mandana
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.4
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    • pp.267-273
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    • 2016
  • Background: Cystic fibrosis (CF) is an autosomal recessive disorder with several clinical presentations. This study was undertaken in the Azeri Turkish population in Iran, to investigate gender differences in the age at onset and diagnosis, age of death, and duration of illness of CF. Methods: The data of 331 CF patients from 2001 to 2015 was surveyed. Parameters including age, sex, ${\Delta}F508$ mutation, age at onset, age at diagnosis, age of death and clinical presentations were evaluated for both sexes, using descriptive analysis. The association of gender with these variables was studied using logistic regression, chi-square test and Mann-Whitney U test by SPSS version 18. Odds ratio with a confidence interval of 95% and $p{\leq}0.05$ was considered statistically significant. Results: The study included 191 males (57.7%) and 140 females (42.3%), all showing statistically significant difference (p<0.001). Age duration differed between genders. Male and female patients were further under 9 and 4 years, respectively. The occurrence of ${\Delta}F508$ mutation was 0.51 times more in females than in males. Age, diagnosis and sex were closely associated: males were diagnosed at a significantly later age than females (p=0.05). While this compression performed based on clinical presentations, males with respiratory disease had a later median age at diagnosis than females at lifespan (p=0.001). The risk of infertility in males was approximately two times greater than in females (p=0.02). Conclusion: These findings indicate gender differences in CF patients. Future studies are needed to establish other differences and evaluate the causes for the gender variations.

Role of Endoscopic Ultrasound-Guided Fine-Needle Aspiration in the Evaluation of Abdominal Lymphadenopathy of Unknown Etiology

  • Nonthalee Pausawasdi;Kotchakon Maipang;Tassanee Sriprayoon;Phunchai Charatcharoenwitthaya
    • Clinical Endoscopy
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    • v.55 no.2
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    • pp.279-286
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    • 2022
  • Background/Aims: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is a standard procedure for obtaining tissue from lesions near the gastrointestinal lumen. However, there is a scarcity of information on the diagnostic performance of EUS-FNA for abdominal lymphadenopathy of unknown causes. To assess the accuracy of EUS-FNA in diagnosing abdominal lymphadenopathy of unknown etiology. Methods: The EUS records of patients with undiagnosed abdominal lymphadenopathy between 2010 and 2015 were reviewed. Results: A total of 42 patients were included in this study. Adequate specimens were obtained from 40 patients (95%). The final diagnoses were metastatic cancer (n=16), lymphoma (n=9), tuberculosis (n=8), inflammatory changes (n=6), and amyloidosis (n=1). For diagnosing malignancy, EUS-FNA had a sensitivity of 84.6%, specificity of 95.7%, positive predictive value of 91.7%, negative predictive value of 91.7%, and area under the receiver operating characteristic curve (AUROC) of 0.901. For the diagnosis of lymphoma, EUS-FNA was 100% accurate when combined with cytologic evaluation and immunohistochemical staining. The diagnostic sensitivity decreased to 75%, whereas the specificity remained 100%, for tuberculosis. The overall AUROC was 0.850. No procedure-related complications occurred. Conclusions: EUS-FNA showed high diagnostic performance for abdominal lymphadenopathy of unknown causes, especially malignancy, lymphoma, and tuberculosis. Therefore, it is a crucial diagnostic tool for this patient population.

Disseminated BCG Infection in a patient with Severe Combined Immunodeficiency

  • Tae Il Han;In-One Kim;Woo Sun Kim;Kyung Mo Yeon
    • Korean Journal of Radiology
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    • v.1 no.2
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    • pp.114-117
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    • 2000
  • Disseminated mycobacterial infection after bacillus Calmette-Guerin (BCG) vaccination is a very rare disorder, occurring mostly in patients with immunologic deficiency. We report a case of disseminated BCG infection in a 16-month-old girl with severe combined immunodeficiency. Plain radiographs showed multiple osteolytic lesions in the femora, tibiae, humerus, and phalanges. Abdominal sonography and CT scanning revealed multiple nodules in the spleen, and portocaval lymphadenopathy.

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A Case of Pellagra Induced by Isoniazid during Treatment of Pulmonary Tuberculosis (폐결핵 치료중 Isoniazid에 의해 발생한 Pellagra 1례)

  • Jeon, Ho Seok;Han, Min Soo;Ahn, Ju Eui;Lee, Yang Deok;Cho, Yongseon
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.2
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    • pp.180-182
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    • 2004
  • A Case of Pellagra Induced by Isoniazid during Treatment of Pulmonary Tuberculosis Pellagra is a disease caused by a deficiency of nicotinic acid or niacin. It is mostly found among people eating corn-based diets in parts of China, Africa and India. It is also induced by drugs, such as isoniazid or 5-fluorouracil. Isoniazid inhibits the conversion of tryptophan to niacin and may induce pellagra, particularly in poorly nourished patients. Pellagra should be suspected whenever tuberculous patients under the treatment with isoniazid develop mental, neurological or gastrointestinal symptoms, even in the absence of typical skin changes. Herein, our experienced of a case of pellagra induced by isoniazid during treatment of pulmonary tuberculosis is reported. The patient was referred due to a skin rash and drowsy mental status. Her skin lesion developed during treatment for pulmonary tuberculosis. Her symptoms were improved after discontinuation of antituberculous agents and on the administration of nicotinamide.