• Title/Summary/Keyword: Abdominal symptoms

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Primary Hepatosplenic B-cell Lymphoma: linitial Diagnosis and Assessment of Therapeutic Response with F-18 FDG PET/CT (원발성 간비장 B세포성 림프종에서 치료전과 치료 후 F-18 FDG PET/CT 소견)

  • Kang, Sung-Min;Lee, Hong-Je;Seo, Ji-Hyoung;Lee, Sang-Woo;Ahn, Byeong-Cheol;Lee, Jae-Tae
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.4
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    • pp.333-336
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    • 2008
  • A 52-year-old woman with a history of general weakness, fatigue, weight loss, elevated serum levels of liver transaminase enzyme for three months underwent an F-18 FDG PET/CT scan to evaluate a cause of the hepatosplenomegaly found on abdominal ultrasonography. Initial PET/CT revealed markedly enlarged liver and spleen with intense FDG uptake. Otherwise, there were no areas of abnormal FDG uptake in whole body image. Histological evaluation by a hepatic needle biopsy demonstrated diffuse large B cell type lymphoma and final diagnosis for this patient was hepatosplenic B-cell lymphoma. She received five cycles of CHOP chemotherapy, and second PET/CT scan was followed after then. Follow-up PET-CT revealed normal sized liver with disappearance of abnormal FDG uptake. Hepatosplenic B-cell lymphoma is relatively rare and mostly presents as single or multiple nodules.1,2 Diffuse type hepatosplenic lymphoma is extremely rare and poorly recognized entity.3 The diagnosis is very difficult and complicated by the presence of misleading symptoms.4 In this rare hepatosplenic B-cell lymphoma case, F-18 FDG PET/CT scan provided a initial diagnostic clue of hepatosplenic lymphoma and an accurate chemotherapy response.

Lipiodol-induced pneumonitis following transarterial chemoembolization for ruptured hepatocellular carcinoma (파열 간암의 간동맥 항암 화학색전술 후 발생한 유도 폐렴)

  • Kim, Haewon;Kim, Yong Hoon;Yoon, Hong Jin;Lee, Kwang Hoon;Joo, Seung Moon;Byun, Min Kwang;Lee, Jung Il;Lee, Kwan Sik;Kim, Ja Kyung
    • Journal of Yeungnam Medical Science
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    • v.31 no.2
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    • pp.117-121
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    • 2014
  • Transarterial chemoembolization (TACE) is a widely accepted nonsurgical modality used for the treatment of multinodular hepatocellular carcinoma (HCC). The careful selection of the candidate is important due to the risk of developing various side effects. Fever, nausea, abdominal pain, and liver enzyme elevation are commonly known side effects of TACE. Hepatic failure, ischemic cholecystitis, and cerebral embolism are also reported, although their incidence might be low. Pulmonary complication after TACE is rare, and the reported cases of lipiodol pneumonitis are even rarer. A 53-year-old man was treated with TACE for ruptured HCC associated with hepatitis B virus infection. On day 19 after the procedure, the patient complained of dyspnea and dry cough. Chest computed tomography showed diffuse ground glass opacities in the whole-lung fields, suggesting lipiodol-induced pneumonitis. After 2 weeks of conservative management, the clinical symptoms and radiologic abnormalities improved. Reported herein is the aforementioned case of lipiodol-induced pnemonitis after TACE, with literature review.

The Clinical Study One Pelvic Inflammatory Disease (PID) Patient Treatments by Korean Medicine (골반염 환자에 대한 한방치료 치험 1례)

  • Song, Yu-Rim;Kim, Ji-Uun;Yang, Seung-Jeong;Park, Kyung-Mi;Jung, Su-Jung;Cho, Seong-Hee
    • The Journal of Korean Obstetrics and Gynecology
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    • v.27 no.3
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    • pp.158-167
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    • 2014
  • Objectives: This study aims to report the effect of Korean medicine treatments on a pelvic inflammatory disease (PID). Methods: The patient was treated with Qingbaozhuyu-tang, acupuncture at Jungwan (CV12), Gihae (CV6), Taechung (LR3), Hapgok (LI4), Sameumgyo (SP6), Sangryo (BL3), Charyou (BL32), Jungryo (BL33), Haryo (BL34), Cheonchu (ST25), Pungryung (ST40), Duyu (ST8), Taeyang (EX-HN5). And we evaluated treatment effects by visual analogue scale (VAS) and Urine analysis (UA) Finding. Results: After treatments, the symptoms such as lower abdominal pain, pelvic pain and fever were improved and there were no abnormal findings in urine analysis. Conclusions: This study suggests that Korean medicine treatments show effective on PID treatment.

Trends in Clinical Research of Herbal Medicine Treatment for Functional Gastrointestinal Disorders in Children - Focused on Randomized Controlled Trials in traditional Chinese medicine (소아 기능성 위장 장애의 한약 치료에 대한 임상연구 동향 - 중의학 무작위 대조군 임상시험을 중심으로)

  • Lee, Jihong;Lee, Sun Haeng;Chang, Gyu Tae
    • The Journal of Pediatrics of Korean Medicine
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    • v.35 no.3
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    • pp.67-88
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    • 2021
  • Objectives The purpose of this study is to analyze randomized clinical trials (RCTs) on traditional Chinese medicine to summarize its efficacy and safety for the treatment of functional gastrointestinal disorders (FGIDs) in children. Methods We searched literatures published up to March 19, 2021 using two Chinese electronic databases. Data regarding patients, interventions, results, and adverse events were extracted from RCTs of herbal medicine for children with FGIDs. Results A total of 34 RCTs were included: 16 trials on functional dyspepsia, 7 trials on functional constipation, 6 trials on functional abdominal pain, 4 trials on irritable bowel syndrome, and 1 trial on functional diarrhea. 26 of 29 trials that reported total effective rate, the treatment group showed a significant improvement compared to the control group. Most of other evaluation indicators, such as symptom score, symptom disappearance time, and recurrence rate also demonstrated statistically significant improvement. Of the 16 studies which reported safety, 5 studies reported no adverse reactions in either group, and 4 studies reported no statistically significant differences in the incidence of adverse events between two groups. Also, reported adverse events were mostly mild. Conclusions Herbal medicine may help improve symptoms of FGIDs in children. However, due to limited types of studies on sub-diseases of FGIDs and small sample sizes in each study, additional large scale clinical studies on various other FGIDs are necessary.

Effects of a low-FODMAP enteral formula on diarrhea on patients in the intensive care unit

  • Bae, Eunjoo;Kim, Jiyoon;Jang, Jinyoung;Kim, Junghyun;Kim, Suyeon;Chang, Youngeun;KIM, MI YEON;Jeon, Mira;Kang, Seongsuk;Lee, Jung Keun;Kim, Tae Gon
    • Nutrition Research and Practice
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    • v.15 no.6
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    • pp.703-714
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    • 2021
  • BACKGROUND/OBJECTIVES: A dietary restriction on the intake of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) has been reported to be effective in the treatment of gastrointestinal (GI) tract complications. Enteral nutrition (EN) is widely used for patients who cannot obtain their nutritional requirements orally, but many studies have reported EN complications, especially diarrhea, in up to 50% of patients. SUBJECTS/METHODS: We performed a single-center, non-randomized, controlled trial to determine the effects of a low-FODMAP enteral formula on GI complications in patients in intensive care units (ICUs). Patients in the ICU who needed EN (n = 66) were alternately assigned to the low-FODMAP group (n = 33) or the high-FODMAP group (n = 33). RESULTS: Anthropometric and biochemical parameters were measured, and stool assessment was performed using King's Stool Chart. We excluded patients who received laxatives, GI motility agents, proton pump inhibitors, antifungal agents, and antibiotics other than β-lactams. There were no differences in GI symptoms during 7 days of intervention, including bowel sound, abdominal distension, and vomiting between the 2 groups. However, diarrhea was more frequent in the high-FODMAP group (7/33 patients) than the low-FODMAP group (1/33 patients) (P = 0.044). CONCLUSIONS: Our results suggest that a low-FODMAP enteral formula may be a practical therapeutic approach for patients who exhibit enteral formula complications. Our study warrants further randomized clinical trials and multicenter trials.

Effects of red ginseng on gut, microbiota, and brain in a mouse model of post-infectious irritable bowel syndrome

  • Yu, Seonhye;Chun, Eunho;Ji, Yeounjung;Lee, Young Joo;Jin, Mirim
    • Journal of Ginseng Research
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    • v.45 no.6
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    • pp.706-716
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    • 2021
  • Background: Irritable bowel syndrome (IBS), the most common functional gastrointestinal disorder, is characterized by chronic abdominal pain and bowel habit changes. Although diverse complicated etiologies are involved in its pathogenesis, a dysregulated gut-brain axis may be an important factor. Red ginseng (RG), a traditional herbal medicine, is proven to have anti-inflammatory effects and improve brain function; however, these effects have not been investigated in IBS. Methods: Three-day intracolonic zymosan injections were used to induce post-infectious human IBS-like symptoms in mice. The animals were randomized to receive either phosphate-buffered saline (CG) or RG (30/100/300 mg/kg) for 10 days. Amitriptyline and sulfasalazine were used as positive controls. Macroscopic scoring was performed on day 4. Visceral pain and anxiety-like behaviors were assessed by colorectal distension and elevated plus maze and open field tests, respectively, on day 10. Next-generation sequencing of gut microbiota was performed, and biomarkers involved in gut-brain axis responses were analyzed. Results: Compared to CG, RG significantly decreased the macroscopic score, frequency of visceral pain, and anxiety-like behavior in the IBS mice. These effects were comparable to those after sulfasalazine and amitriptyline treatments. Moreover, RG significantly increased the proliferation of beneficial microbes, including Lactobacillus johnsonii, Lactobacillus reuteri, and Parabacteroides goldsteinii. RG significantly suppressed expression of IL-1β and c-fos in the gut and prefrontal cortex, respectively. Further, it restored the plasma levels of corticosterone to within the normal range, accompanied by an increase in adrenocorticotropic hormone. Conclusion: RG may be a potential therapeutic option for the management of human IBS.

A Comparative Clinical Trial to Evaluate the Efficacy and Safety of 'Hwangryunhaedok-tang' in Treatment of Gastritis : Study Protocol (위염 환자를 대상으로 황련해독탕 투여에 따른 치료효과, 안전성 평가를 위한 단일 비교 임상 연구 : 임상연구 프로토콜)

  • Kim, Hee-Yeon;Choi, Jun-Yong;Cheon, Jin-Hong;Kim, Kyung ho;Kim, Kwang-Youn;Oh, Tae-woo;Kim, Young woo;Park, Kwang Il;Kim, Kibong
    • Herbal Formula Science
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    • v.27 no.3
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    • pp.213-221
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    • 2019
  • Objectives : The purpose of this study is to confirm the efficacy and safety of the treatment of gastritis with 'Hwangryunhaedok-tang'. Methods : Total 20 people, between 19 and 65 years old, will be recruited to participate in a comparative clinical trial. All subjects will take 2 capsules of Hwangryunhaedok-tang (Redoxin Cap.), 3 times a day, 30 minutes after meals, for 8 weeks. Outcomes will be measured at the baseline, 4th week, and 8th week. Primary outcomes is the improvement rates of gastritis symptoms, such as heartburn, nausea/vomiting, abdominal bloating, anorexia, heartburn, and trim. Results : This trial was approved by institutional review board of Pusan National University Korean Medicine Hospital (registry number: 2018011), and registered in Clinical Research information Service, one of WHO. Recruitment opened in April 2019 and is supposed to be completed by December 2019. Conclusions : This trial will provide clinical information to determine the efficacy and safety of treatment of gastritis with 'Hwangryunhaedok-tang'.

Mirror Syndrome Resulting from Metastatic Congenital Neuroblastoma to Placenta

  • Park, Sung Hyeon;Namgoong, Jung-Man;Ko, Kyeong Nam;Kim, Chong Jai;Lee, Pil-Ryang;Jung, Euiseok;Lee, Byong Sop;Kim, Ki-Soo;Kim, Ellen Ai-Rhan
    • Perinatology
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    • v.29 no.4
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    • pp.189-194
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    • 2018
  • Congenital neuroblastoma is a rare disease. Placental metastasis is extremely rare and poor prognosis has been reported in neonates. Mirror syndrome could occur in mother with placental metastasis with possibilities of hypertension and edema. We report a case of detection of left suprarenal mass in fetus at $31^{+5}weeks^{\prime}$ gestation. Mother presented with palpitation, edema, headache, and hypertension. Maternal 24 hours urine vanillylmandelic acid (VMA) and normetanephrine (NME) level at 34 weeks' gestation were elevated. Consequently, emergent cesarean section was done. Based on abdominal ultrasonography and whole body magnetic resonance imaging, left adrenal tumor with liver metastasis was suspected. Neuroblastoma was confirmed by liver and placenta biopsy. Chemotherapy was started with Pediatric Oncology Group 9243 at day 7 and changed into Children's Oncology Group 3961 due to cholestasis and poor response during 2nd cycle. Plasma exchange was done for aggravated direct hyperbilirubinemia. The baby expired at 73 days due to multi-organ failure. Maternal symptoms were completely resolved in 2 weeks after delivery along with normalization of the elevated level of VMA and NME. We report a first case of mirror syndrome in Korean mother and fetus resulting from metastatic congenital neuroblastoma to placenta.

A Case Report of Intergrative Korean Medicine on Paralytic Ileus Caused by Ovarian Cancer (난소암으로 유발된 마비성 장폐색에 대한 한의 복합치료 치험 1례)

  • Choi, Min-Young;Kim, Gyu-Tae;Park, Nam-Gyeong;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bock;Hwang, Deok-Sang
    • The Journal of Korean Obstetrics and Gynecology
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    • v.34 no.4
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    • pp.163-174
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    • 2021
  • Objectives: The purpose of this study is to report the improvement of paralytic ileus caused by ovarian cancer after integrative Korean Medicine treatment. Methods: The patient who complained paralytic ileus caused by ovarian cancer was treated by acupuncture, electroacupunture, moxibustion, and herbal medicine for 13 days. The effect of treatment was evaluated by abdominal X-ray, dietary change of patient, Numeral Rating Scale (NRS) and blood examination including white blood cell (WBC), creactive protein(CRP), erythrocyte sedimentation rate (ESR), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and electrocytes. Results: After the treatment, the patient could have taken with her mouth. In addition, the clinical symptoms were improved with no adverse event. Conclusions: This case shows that paralytic ileus caused by ovarian cancer was improved after the integrative Korean Medicine treatment. Therefore, it can be effective an complementary option for paralytic ileus caused by ovarian cancer.

Atypical Hemolytic Uremic Syndrome after Traumatic Rectal Injury: A Case Report

  • Kang, Ji-Hyoun;Lee, Donghyun;Park, Yunchul
    • Journal of Trauma and Injury
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    • v.34 no.4
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    • pp.299-304
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    • 2021
  • Atypical hemolytic uremic syndrome (aHUS) is a rare, progressive, life-threatening condition of thrombotic microangiopathy characterized by thrombocytopenia, microangiopathic hemolytic anemia, and renal impairment. The mechanisms underlying aHUS remain unclear. Herein, we present the first case in the literature of aHUS after a traumatic injury. A 55-year-old male visited the emergency department after a traumatic injury caused by a tree limb. Abdominal computed tomography revealed a rectal wall defect with significant air density in the perirectal space and preperitoneum, implying rectal perforation. Due to the absence of intraperitoneal intestinal perforation, we performed diverting sigmoid loop colostomy. An additional intermittent simple repair was performed due to perianal and anal injuries. One day postoperatively, his urine output abruptly decreased and serum creatinine level increased. His platelet level decreased, and a spiking fever occurred after 2 days. The patient was diagnosed with acute renal failure secondary to aHUS and was treated with fresh frozen plasma replacement. Continuous renal replacement therapy (CRRT) was also started for oliguria and uremic symptoms. The patient received CRRT for 3 days and intermittent hemodialysis thereafter. After hemodialysis and subsequent supportive treatment, his urine output and renal function improved. The hemolytic anemia and thrombocytopenia also gradually improved. Dialysis was terminated on day 22 of admission and the patient was discharged after recovery. This case suggests that that a traumatic event can trigger aHUS, which should be considered in patients who have thrombocytopenia and acute renal failure with microangiopathic hemolytic anemia. Early diagnosis and appropriate management are critical for favorable outcomes.