• Journal of The Korean Society of Clinical Toxicology
• /
• v.2 no.1
• /
• pp.58-62
• /
• 2004

Acid ingestion can cause not only caustic injury on esophagus and stomach but also fatal outcome through systemic complications. We report the case of a patient who died early after severe caustic injury with strong acid. A 38-year-old man who ingested about 400ml of hydrochloric acid of unknown concentration was transferred to our hospital from a private clinic, in which he was managed with gastric irrigation through a nasogastric tube. He was complaining dyspnea and abdominal pain. Physical examination demonstrated tenderness and rebound tenderness on epigastric region. Severe metabolic acidosis and leukocytosis were noted. Radiological findings suggested perforation of gastrointestinal tract, although the physical signs were not typical. Endoscopy revealed caustic injuries of grade I on esophagus and of grade Ⅲ on stomach, which indicate more severe injury on the stomach than on the esophagus. Exploratory surgery was recommended but unfortunately not permitted by his family. Despite intensive measures, his vital signs deteriorated rapidly and he died 50 hours after the ingestion.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.7 no.1
• /
• pp.1-9
• /
• 2009

Purpose: Paraquat, a globally used herbicide, is highly toxic to human beings. Hence, we reviewed some cases of paraquat poisoning in Korea. Methods: We analyzed the clinical and laboratory findings of 50 patients poisoned with paraquat retrospectively. The patients were admitted to the department of internal medicine in the Eumseong KeumWang hospital from January 2008 to December 2008. Results: Among 50 cases of paraquat poisoning, 28 cases were male. Twenty-four cases (48%) were over 60 years old. Fourty-nine patients ingested paraquat on purpose as suicidal attempts, while 1 patient underwent accidental ingestion. Seven patients swallowed less than one mouthful of paraquat, of which 4 patients survived. Eleven patients swallowed two mouthfuls of paraquat, of which 8 patients survived. Thirty-two patients swallowed over three mouthfuls of paraquat and they all died. Thirty-one patients with leukocytosis died. Twenty-one patients with metabolic acidosis died. Increased levels of blood amylase and glucose were related to high mortality, and increased level of blood creatinine was related to severe mortality. Hemoperfusions were accomplished in 27 patients of paraquat poisoning, of which 12 patients survived. Conclusion: Paraquat is a highly toxic herbicide. When patients arrive at the hospital, laboratory findings, urine paraquat concentrations, arrival time, and the amount of paraquat consumed must be considered for treatment plan.

• Journal of Veterinary Clinics
• /
• v.32 no.4
• /
• pp.366-369
• /
• 2015

A 12-year-old, castrated male, mixed-breed dog was referred to us with a history of depression, lameness, neck and multiple joints pain. Clinical signs had been deteriorating from rear limbs lameness leading to pain on all four limbs lameness for 7 days. Mild leukocytosis and increased C-reactive protein concentration were revealed in blood work. On radiography, degenerative change of humerus and cervical intervertebral space narrowing were found. The results of synovial fluid analysis revealed severe neutrophilic pleocytosis, decreased viscosity, increased turbidity and bacterial culture was negative. The antinuclear antibody test was negative and MRI results revealed mild cervical intervertebral disk disease (IVDD). Based on all tests, we diagnosed this case as idiopathic immune-mediated polyarthritis (IMPA). Prednisolone and mycophenolate mofetil were administered and clinical signs were resolved after 7 days. This case report demonstrated that clinical, diagnostic imaging and synovial fluid analysis findings and successful treatment result with prednisolone and mycophenolate mofetil in canine idiopathic IMPA.

• Journal of Veterinary Clinics
• /
• v.32 no.4
• /
• pp.370-373
• /
• 2015

A 10-year-old, intact female, Maltese dog was presented with a two weeks history of vomiting, anorexia and weight loss. Hematologic analysis revealed mild leukocytosis and increased liver enzyme. Gaseous dilation of small intestine and hyperechoic nodules of hepatic lobes were revealed on the imaging studies. Liver biopsy was performed through laparotomy and histopathologic results revealed liver cirrhosis with precancerous lesions. Two days later, endoscopy was performed and histopathologic results of the specimens taken by endoscopic biopsy showed gastric adenoma. The gastric surgery was not performed by the owner's request. The patient died after 60 days of diagnosis of gastric adenoma. This case describes clinical features, imaging studies, endoscopic features and histopathologic characteristics of gastric adenoma in a Maltese dog.

• Journal of Veterinary Clinics
• /
• v.32 no.4
• /
• pp.338-342
• /
• 2015

A 12-year-old castrated male miniature Schnauzer had anorexia, vomiting, lethargy, and fever for four days. The dog had leukocytosis, thrombocytopenia, hypoglycemia, hypoalbuminemia, hyperbilirubinemia, increased hepatic enzymes on hematologic and biochemical examinations. On abdominal ultrasonographs, there was an enlarged gallbladder with hyperechoic irregular wall thickening. Echocardiography showed vegetative change and regurgitation of aortic and mitral valves. E.coli was identified through ultrasound guided percutaneous cholecystocentesis and bile culture. Bacterial cholecystitis and concurrent endocarditis were diagnosed. The dog was recovered from sepsis with antibacterial and aggressive supportive therapy.

• Journal of Veterinary Clinics
• /
• v.25 no.6
• /
• pp.526-528
• /
• 2008

A 4-year-old male Maltese dog was referred with chief complaint of facial nerve paralysis and hyperthermia. These clinical signs were occurred after tooth extraction. Leukocytosis and swelling of left side of gums were detected. He was medicated with antibiotics for 9 days, however, inability of blinking in left eye, lacrimation and hyperthermia were not improved. The patient was administrated with Oyaksungisan (50 mg/kg, PO, BID) for 14 days and was treated by injection-acupuncture (AP) with bee venom ($200\;{\mu}g/head$, two times/week, total three times). The patient was treated by injection-AP with dexamethasone (1 mg/kg, two times/week, total two times). As a result, Left blepharon was slightly blinked at session 4. Blinking of left blepharon became normal after session 5. The present patient was a case with canine facial nerve paralysis which showed favorable therapeutic response by alternative treatment.

• Journal of Veterinary Clinics
• /
• v.37 no.4
• /
• pp.231-234
• /
• 2020

An 11-year-old, 4.3 kg, mixed breed, intact female dog exhibiting vomiting and a reduced appetite was presented. On physical examination, palpation of the right kidney elicited discomfort. Blood analysis revealed leukocytosis with neutrophilia, and elevation of alkaline phosphatase and blood urea nitrogen. Escherichia coli was detected in urine culture, whereas urine analysis showed absence of glucose. Radiography and ultrasonography suggested that there was gas in the right renal parenchyma, and computed tomography was performed while the dog was awake to investigate the suspected gas in the right kidney. After unilateral ureteronephrectomy, a histological diagnosis of right emphysematous pyelonephritis (EPN) was made. EPN refers to a severe necrotizing infection of the renal parenchyma with gas accumulation in the tissue. It is rare in both human and veterinary medicine, and almost all EPN patients have uncontrolled diabetes mellitus. This case report describes the imaging-based diagnosis of a rare occurrence of unilateral EPN in a non-diabetic dog.

• Parasites, Hosts and Diseases
• /
• v.57 no.4
• /
• pp.411-416
• /
• 2019

To analyze the clinical and endoscopic features of colonic anisakiasis. A retrospective chart review of 20 patients with colonic anisakiasis, who were diagnosed by colonoscopy at 8 hospitals between January 2002 and December 2011, was performed. Patients' mean age was $53.6{\pm}10.74years$. Seventy percent patients were men. Acute abdominal pain was a common symptom that mostly developed within 48 hr after the ingestion of raw fish, and which lasted for 1-28 days. Sixty percent patients had ingested raw fish before the diagnosis of colonic anisakiasis and 40% patients were incidentally found to have colonic anisakiasis during the screening colonoscopies. Leukocytosis and eosinophilia were each found in 20% of the patients. In all patients who underwent colonoscopy, the worms were removed with biopsy forceps, except in 1 case, and a definite diagnosis of anisakiasis was made. In some cases of colonic anisakiasis, colonoscopy may be helpful in the diagnosis and treatment to avoid surgical intervention.

• Journal of Veterinary Clinics
• /
• v.37 no.6
• /
• pp.360-362
• /
• 2020

A 12-year-old intact female Pomeranian dog was presented with vulvar discharge, lethargy, polyuria, and polydipsia. A complete blood count revealed leukocytosis and anemia. The serum biochemical analyses showed elevated serum alkaline phosphatase activity and blood urea nitrogen. Survey abdominal radiography revealed an enlarged left kidney. Abdominal ultrasonography identified multiple rounded hypoechoic subcapsular lesions in the left kidney. The bilateral uterine horn was enlarged, and contained echogenic fluid. Percutaneous ultrasonographic-guided aspiration of the renal subcapsular lesions was performed on the left kidney. Cytological examination revealed bacterial cocci, degenerated neutrophils, and suppurative inflammation. Bacterial culture produced growth of Escherchia coli. Left nephrectomy and ovariohysterectomy were performed. Dilated uterine fluid was also evaluated for bacterial culture, and showed growth of E. coli. Urine was examined by bacterial culture, and showed negative results. The treatment consisted of antibiotic therapy according to the antibiotic sensitivity test. Based on these findings, the diagnosis was renal subcapsular abscess associated with pyometra. This study suggests that pyometra should be considered as the cause of renal abscess.

• Journal of Veterinary Clinics
• /
• v.37 no.6
• /
• pp.350-354
• /
• 2020

Feline chronic lymphocytic leukemia (CLL) is a rare disease. Its diagnosis is not simple because of the absence of clinical signs and the presence of mature lymphocytosis. An 11-year-old female spayed Russian Blue cat was referred to the veterinary medical teaching hospital for lethargy, diarrhea, weight loss, and inappetence. Marked lymphocytic leukocytosis and a significantly increased number of small-to-intermediate-sized lymphocytes in the peripheral blood were found on hematological examination. The results of the feline leukemia virus and immunodeficiency virus test were negative. Further, mild splenomegaly was detected. Bone marrow aspirate analysis revealed mature lymphocytosis and a clonally rearranged T cell receptor gene with the polymerase chain reaction (PCR) for antigen receptor rearrangement assay. Flow cytometric immunophenotyping showed a homogeneous population of CD5+/CD21-T-cells in the peripheral blood and bone marrow. According to the results of the aforementioned examinations, CLL was diagnosed. Treatment was not initiated at the time of diagnosis because the clinical signs were mild and did not affect the quality of life. This report describes the clinical findings and use of advanced diagnostic tools such as molecular clonality analysis and immunophenotyping for the diagnosis of feline CLL.