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Three Year Old Male with Multiple Dieulafoy Lesions Treated with Epinephrine Injections via Therapeutic Endoscopy

  • Baldwin, Christina L.;Wilsey, Michael
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.19 no.4
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    • pp.276-280
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    • 2016
  • Dieulafoy lesions, vascular anomalies typically found along the gastrointestinal tract, have been viewed as rare and obscure causes of sudden intestinal bleeding, especially in pediatric patients. Since their discovery in the late 19th century, the reported incidence has increased. This is due to an increased awareness of, and knowledge about, their presentation and to advanced endoscopic diagnosis and therapy. Our patient was a three-year-old male, without a complex medical history. He presented to the emergency department with acute hematemesis with blood clots and acute anemia requiring blood transfusion. Endoscopy revealed four isolated Dieulafoy lesions along the lesser curvature of the stomach, which were treated with an epinephrine injection. The Dieulafoy lesion, although thought to be rare, should be considered when investigating an acute gastrointestinal bleed. These lesions have been successfully treated endoscopically. Appropriate anticipation and preparation for diagnosis and therapy can lead to optimal outcomes for the pediatric patient.

Acute Myelopathy Caused by a Cervical Synovial Cyst

  • Kim, Dong Shin;Yang, Jin Seo;Cho, Yong Jun;Kang, Suk Hyung
    • Journal of Korean Neurosurgical Society
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    • v.56 no.1
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    • pp.55-57
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    • 2014
  • Synovial cysts of the cervical spine, although they occur infrequently, may cause acute radiculopathy or myelopathy. Here, we report a case of a cervical synovial cyst presenting as acute myelopathy after manual stretching. A 68-year-old man presented with gait disturbance, decreased touch senses, and increased sensitivity to pain below T12 level. These symptoms developed after manual stretching 3 days prior. Computed tomography scanning and magnetic resonance imaging revealed a 1-cm, small multilocular cystic lesion in the spinal canal with cord compression at the C7-T1 level. We performed a left partial laminectomy of C7 and T1 using a posterior approach and completely removed the cystic mass. Histological examination of the resected mass revealed fibrous tissue fragments with amorphous materials and granulation tissue compatible with a synovial cyst. The patient's symptoms resolved after surgery. We describe a case of acute myelopathy caused by a cervical synovial cyst that was treated by surgical excision. Although cervical synovial cysts are often associated with degenerative facet joints, clinicians should be aware of the possibility that these cysts can cause acute neurologic symptoms.

A Case of Asymptomatic, Localized, and Idiopathic Diffuse Alveolar Damage

  • Jeon, Young-Do;Hong, Christian;Joh, Joon-Sung;Jung, Ja-Young;Min, Ji-Won;Park, Seon-Young;Lee, Ga-Ram
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.4
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    • pp.386-389
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    • 2012
  • Diffuse alveolar damage (DAD) is a histological change in lung tissue, and is generally caused by an acute lung injury, which is characterized by bilateral and widespread damages. Localized DAD occurs very rarely. The causes for DAD are numerous, but the chief cause is acute interstitial pneumonia or acute exacerbation of idiopathic interstitial pneumonia, in cases of idiopathic manifestation. The 82-year-old patient, in this case study, showed a DAD lesion in only 1 lobe. The patient was otherwise healthy, with no previous symptoms of DAD. He was admitted to our medical center owing to localized infiltration, observed on his chest radiograph. Laboratory studies showed no signs of infections. DAD was confirmed by a surgical lung biopsy. The patient received corticosteroid treatment and had gradually improved. We report the case of a patient with localized, idiopathic DAD that cannot be classified as acute interstitial pneumonia or acute exacerbation of idiopathic interstitial pneumonia.

A Case of Secondary Acute Lymphangitis with Tinea Pedis (족부 백선에 동반된 속발성 급성 림프관염 1례)

  • Jeong, Mi-rae;Heo, Eun-na;Kwon, Kang;Seo, Hyung-sik
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.35 no.4
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    • pp.219-224
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    • 2022
  • Objectives : The study is to report a case of acute lymphangitis with tinea pedis treated with pharmacopuncture(Bee venom, Soyeom) and Yeonkyopaedok-san. Methods : The mixed pharmacopuncture(Bee venom, Soyeom) was applied to the lesion area for 7 days, and Yeonkyopaedok-san was administered for 9 days for antibacterial and anti-inflammatory effects. Results : After treatment, the symptoms of acute lymphangitis disappeared, and the treatment duration and effect were similar to those when antibiotics were used. Conclusions : Acute lymphangitis can be treated through herbal medicines with anti-inflammatory and antibacterial effects.

Acute Intervertebral Disc Protrusion in a Korean Domestic Shorthaired Cat: Clinical and MRI Findings

  • Lee, Narae;Lee, Young-jae;Song, Jin-young;An, Dae-gi;Kang, Byeung-taek;Chang, Jin-hwa;Chang, Dong-woo
    • Journal of Veterinary Clinics
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    • v.34 no.6
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    • pp.467-469
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    • 2017
  • Signalment: A 7-month-old, female domestic shorthaired cat was presented for acute pelvic limb paraparesis. Results: There was no abnormality on survey radiographs and blood analysis, however neurological examination revealed proprioception positioning and hopping was absent in the pelvic limbs. Also, anal tone and perineal sensation were reduced. Magnetic resonance (MR) imaging showed nucleus pulposus dehydration and disc protrusion at T12-T13. Ill-defined diffuse lesion was found at T10-L2 level and it showed isointense on T1-weighted images and hyperintense on T2-weighted and FLAIR images. This lesion was considered as edematous lesion secondary to disc protrusion. The presumptive diagnosis was focal spinal cord edema associated with intervertebral disc protrusion. A traumatic aetiology was suspected. The cat was treated corticosteroids and analgesic and clinical sign improved following 9 days of treatment. Clinical relevance : Intervertebral disc protrusion is rare disease in a cat. However, it could be considered as a cause of paraparesis in cats.

Protective effect of ginsenoside Re on acute gastric mucosal lesion induced by compound 48/80

  • Lee, Sena;Kim, Myung-Gyou;Ko, Sung Kwon;Kim, Hye Kyung;Leem, Kang Hyun;Kim, Youn-Jung
    • Journal of Ginseng Research
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    • v.38 no.2
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    • pp.89-96
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    • 2014
  • The protective effect of ginsenoside Re, isolated from ginseng berry, against acute gastric mucosal lesions was examined in rats with a single intraperitoneal injection of compound 48/80 (C48/80). Ginsenoside Re (20 mg/kg or 100 mg/kg) was orally administered 0.5 h prior to C48/80 treatment. Ginsenoside Re dose-dependently prevented gastric mucosal lesion development 3 h after C48/80 treatment. Increases in the activities of myeloperoxidase (MPO; an index of neutrophil infiltration) and xanthine oxidase (XO) and the content of thiobarbituric acid reactive substances (TBARS; an index of lipid peroxidation) and decreases in the contents of hexosamine (a marker of gastric mucus) and adherent mucus, which occurred in gastric mucosal tissues after C48/80 treatment, were significantly attenuated by ginsenoside Re. The elevation of Bax expression and the decrease in Bcl2 expression after C48/80 treatment were also attenuated by ginsenoside Re. Ginsenoside Re significantly attenuated all these changes 3 h after C48/80 treatment. These results indicate that orally administered ginsenoside Re protects against C48/80-induced acute gastric mucosal lesions in rats, possibly through its stimulatory action on gastric mucus synthesis and secretion, its inhibitory action on neutrophil infiltration, and enhanced lipid peroxidation in the gastric mucosal tissue.

Focal Bacterial Nephritis (Lobar Nephronia) in a Four- Month Old Boy (국소성 세균성 신염 (Lobar Nephronia) 1례)

  • Ahn Hye Young;Pai Ki-Soo;Oh Seung Hwan;Lee Jin Yong;Kim Pung-Kil;Lee Jae Seung
    • Childhood Kidney Diseases
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    • v.5 no.1
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    • pp.73-77
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    • 2001
  • Acute lobar nephronia is a focal of acute bacterial nephritis, affecting one or more of the renal lobules. Nephronia is being diagnosed more frequently in accordance with the advancing imaging techniques of urinary tract. We report a case of acute nephronia in a 4 month old boy who presented persisting urinary tract infection after intial antibiotic treatment. Ultrasonography and computerized tomography showed round wedge-shaped, non-enhancing mass in right kidney. Gallium scan also revealed the lesion in the right kidney. This lesion resolved completely on one month follow up examinations. (J. Korean Soc Pediatr Nephrol 5 : 73- 7, 2001)

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Acute Oral Toxicity Studies of 1:1 mixture of Phellodendron amurense cortex and Arabia elata cortex P55A in SD Rats and Beagle Dogs (두릅나무와 황백피의 혼합추출물 P55A의 랫트 및 개에 대한 경구투여 급성독성)

  • 강부현;손화영;송시환;차신우;서동욱;정영신;홍은경;김해리
    • Biomolecules & Therapeutics
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    • v.7 no.2
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    • pp.185-190
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    • 1999
  • The current study was performed to determine the acute oral toxicity of P55A, a crude extract of 1 : 1 mixture of Phellodendron amurense cortex and Aralia elata cortex, in SD rats and beagle dogs. 5 rats of each sex were treated with a single dose of P55A orally at doses of 0 and 5,000 mg/kg respectively. Also 2 dogs of each sex were treated with a single dose of P55A orally at doses of 0 and 2,000 mgAg, respectively. After the treatment, clinical signs, and body weight change were observed for 14 days. All rats survived during the study and did not show any clinical sign. Body weight gain showed no significant difference between the control and treated rats. Grossly, no lesion was observed in the rats. All dogs survived during the study. In clinical signs, dark stool was observed in the 2,000 mg/kg treated dogs at day 1 after administration. The animals recovered from general signs at day 2 after administration. Body weight gain showed no significant difference between the control and treated dogs. Grossly, no lesion was observed in the dogs. It is suggested that the LD$_{50}$ of P55A by oral administration was estimated to be over 5,000 mg/kg in both sexes of rats and 2,000 mg/kg in both sexes of beagle dogs.s.

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Chitin from the Extract of Cuttlebone Induces Acute Inflammation and Enhances MMP1 Expression

  • Lee, Ki Man;Shim, Hong;Lee, Geum Seon;Park, Il Ho;Lee, Ok Sang;Lim, Sung Cil;Kang, Tae Jin
    • Biomolecules & Therapeutics
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    • v.21 no.3
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    • pp.246-250
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    • 2013
  • We previously reported that the extract from cuttlebone (CB) has wound healing effect in burned lesion of rat. In present study, the main component of CB extract was analyzed and its wound healing activity was evaluated by using in vitro acute inflammation model. The extract of CB stimulated macrophages to increase the production of TNF-${\alpha}$. The extract also enhanced the production of TGF-${\beta}$ and VEGF, which were involved in angiogenesis and fibroblast activation. The treatment with CB extract enhanced proliferation of murine fibroblast. CB extract also induced the activation of fibroblast to increase the secretion of matrix metalloproteases 1 (MMP1). The constituent of CB extract which has wound healing activity was identified as chitin by HPLC analysis. The mechanism that the CB extract helps to promote healing of burned lesion is associated with that chitin in CB extracts stimulated wound skins to induce acute inflammation and to promoted cell proliferation and MMP expression in fibroblast. Our results suggest that CB or chitin can be a new candidate material for the treatment of skin wound such as ulcer and burn.

The Use of Multiple Fenestrations of the Dura in Acute Traumatic Subdural Hematoma in Elderly (노인 급성 외상성 경막하출혈 환자에서 시행한 다발성 경막천공술의 이용)

  • Park, Jongtae;Yun, Jikwang
    • Journal of Trauma and Injury
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    • v.26 no.3
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    • pp.226-228
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    • 2013
  • Elderly patients with acute subdural hematomas have higher mortality and lower functional recovery rates compared with those of other head-injured patients. Early and widely surgical decompression and active intensive care represent the best way to assist these patients. However, abrupt decompression of the hematoma can lead to brain disruption and secondary ischemia in the brain surrounding the craniectomy site. Acute brain swelling and brain extrusion, which take place shortly after decompression, can lead to a catastrophic situation during the operation due to the impossibility of appropriate closure of the dura and scalp. To avoid the deleterious consequences of disruption of brain tissue, we have adopted multiple fenestrations of the dura in a mesh-like fashion and gradual release of subdural clots through the small dural openings that are left open. This is especially important in cases in which there are massive amount of subdural hematomas with small parenchymal lesion and severe midline shifts in elderly patients. Further clinical experiences should be conducted in a more selected series patients to estimate the impact of this technique on morbidity and mortality rates.