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Primary Diffuse B-cell Lymphoma of Uterine Cervix: A Case Report 宫颈原发性弥漫性b细胞淋巴瘤1例
Pub Date : 2022-06-30 DOI: 10.15746/sms.22.011
H. Choi, H. Kim, Jong-Sool Kim
Primary diffuse large B-cell lymphoma (DLBCL) of the female genital tract is a rare case. It is hard to diagnose DLBCL of the uterine cervix before surgery because it is often misdiagnosed as cervical myoma or cervical squamous cell carcinoma. Here, we report a case of cervical DLBCL misdiagnosed as a cervical myoma. A 48-year-old premenopausal woman was referred to the gynecology department due to abnormal uterine bleeding with a normal Papanicolaou smear. The initial diagnosis according to ultrasound and computed tomography was a cervical myoma. She had undergone a hysterectomy with bilateral salpingectomy. The final diagnosis was cervical DLBCL and she was referred to the department of hematology for treatment with Rituximab combined chemotherapy. After six courses of chemotherapy, complete remission was reached. At a 2-year follow-up, the patient is alive without interval change.
摘要原发性弥漫大b细胞淋巴瘤(DLBCL)发生于女性生殖道是一种罕见的病例。宫颈DLBCL术前诊断困难,常被误诊为宫颈肌瘤或宫颈鳞状细胞癌。在此,我们报告一例宫颈DLBCL误诊为宫颈肌瘤。一位48岁的绝经前妇女因子宫异常出血而被转介到妇科,帕氏涂片正常。根据超声和计算机断层扫描初步诊断为宫颈肌瘤。她接受了子宫切除术和双侧输卵管切除术。最终诊断为宫颈DLBCL,转至血液科接受利妥昔单抗联合化疗。经过6个疗程的化疗后,病情完全缓解。在2年的随访中,患者存活,无间隔变化。
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引用次数: 0
A Case of Primary Lymphoma Involving the Heart 原发性淋巴瘤累及心脏1例
Pub Date : 2022-06-30 DOI: 10.15746/sms.22.014
Chan Ho Park
Primary cardiac lymphoma is a rare extranodal malignant lymphoma that involves only the heart and pericardium without dissemination. The prognosis of primary cardiac lymphoma is poor. But, recent advances in imaging diagnosis and chemotherapy have improved survival. We report histologically diagnosed diffuse large B cell lymphoma involving the heart with computed tomography and magnetic resonance imaging images.
原发性心脏淋巴瘤是一种罕见的结外恶性淋巴瘤,仅累及心脏和心包膜而无播散。原发性心脏淋巴瘤预后较差。但是,影像诊断和化疗的最新进展提高了生存率。我们报告病理诊断弥漫性大B细胞淋巴瘤累及心脏的计算机断层扫描和磁共振成像图像。
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引用次数: 0
A Case Report of Isoniazid Induced Encephalopathy 异烟肼致脑病1例报告
Pub Date : 2022-06-30 DOI: 10.15746/sms.22.017
Kyung-Ran Cho, K. Hwang
A 61-year-old male without a prior neurologic history presented with disturbances in consciousness and seizure that were suspected as related to the treatment of tuberculosis with isoniazid. The neurologic symptoms were resolved after isoniazid was discontinued. Clinicians should be aware of the possibility of neurologic symptoms with the use of this agent.
61岁男性,既往无神经系统病史,表现为意识障碍和癫痫发作,怀疑与异烟肼治疗结核病有关。停用异烟肼后,神经系统症状消失。临床医生应注意使用该药后可能出现的神经系统症状。
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引用次数: 0
Usefulness of the ClearSight System in Monitoring Patients with End-Stage Renal Stage: Two Case Reports ClearSight系统在监测终末期肾脏病患者中的作用:两例报告
Pub Date : 2022-06-30 DOI: 10.15746/sms.22.007
Sun Young Park, Wan Mo Koo, J. Chung
Since blood pressure tends to be unstable during surgery, an arterial catheter is often inserted to monitor arterial pressure continuously during general anesthesia. However, there are some situations wherein arterial cannulation is not allowed. ClearSight System enables noninvasive continuous monitoring of arterial pressure and derives variables via a single finger cuff without arterial cannulation. We describe two cases of end-stage renal disease patients who were hemodynamically unstable during surgery. In these cases, rapid and appropriate management was possible using the ClearSight System in a situation where the arterial puncture was difficult.
由于手术期间血压趋于不稳定,因此在全身麻醉期间经常插入动脉导管以持续监测动脉压。然而,在某些情况下,不允许动脉插管。ClearSight系统可以无创地连续监测动脉压力,并通过单个手指套获得变量,而无需动脉插管。我们描述了两例终末期肾脏疾病患者在手术期间血流动力学不稳定。在这些情况下,在动脉穿刺困难的情况下,使用ClearSight系统可以进行快速和适当的管理。
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引用次数: 0
Effect of Stellate Ganglion Block in Patients with Ventricular Electrical Storm: A Case Report 星状神经节阻滞治疗脑室电风暴1例
Pub Date : 2022-06-30 DOI: 10.15746/sms.22.013
Hye-Rim Kwon, Na Eun Kim, Junghyung Lee, Byung Gun Kim, H. Shinn
If cardiac sympathetic activity increases after myocardial injury, a ventricular electrical storm (VES) may occur. The stellate ganglion block is a minimally invasive technique performed to control VES through temporary sympathetic cessation. This case was treated after 3 stellate ganglion blocks in VES developed after non-ST elevation myocardial infarction. This patient underwent prophylactic stellate ganglion block prior to radical nephrectomy for a renal mass found during hospitalization, and the operation was safely completed. Stellate ganglion block is expected to be a safe treatment option for patients with unstable VES.
如果心肌损伤后心脏交感神经活动增加,心室电风暴(VES)可能发生。星状神经节阻滞是一种通过暂时停止交感神经来控制VES的微创技术。本病例在非st段抬高型心肌梗死后发生的VES中行3次星状神经节阻滞治疗。该患者因住院期间发现肾肿块而行根治性肾切除术前预防性星状神经节阻滞,手术安全完成。星状神经节阻滞有望成为不稳定VES患者的安全治疗选择。
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引用次数: 0
Clinical Usefulness of Pelvic Ultrasound in Diagnosis of Precocious Puberty 盆腔超声诊断性早熟的临床价值
Pub Date : 2022-06-30 DOI: 10.15746/sms.22.005
Duk Hyun Kim, S. Jung, Jeongho Lee
Objective: Precocious puberty is the adrenarche that occurs before the age of 8 in girls. Gonadotropin-releasing hormone stimulation test (GnRH stimulation test), which is widely used in diagnosing precocious puberty, is commonly used to evaluate the activity of the hypothalamus-pituitary-gonad axis, but it has the disadvantages of low sensitivity and laborious blood sampling process. On the other hand, pelvic ultrasonography has the advantage of being inexpensive and easy to test. The purpose of this study was to investigate the usefulness of pelvic ultrasonography for the diagnosis of precocious puberty and whether there is a significant relationship between the GnRH stimulation test and ultrasonography findings.Methods: From January 2016 to September 2021, a total of 234 girls with precocious puberty who visited the Soonchunhyang University Seoul Hospital were subjected to pelvic ultrasonography.Results: The size of both ovaries in the group with a peak luteinizing hormone (LH) value of 10 IU/L or higher in the GnRH stimulation test was significantly larger than that of the group with a peak LH value of less than 7 IU/L. A group with a peak LH value of 10 IU/L or higher in the GnRH stimulation test had 0.63 cm and 0.9 cm significantly larger uterus size than that of the other two groups.Conclusion: Uterus and ovary sizes have a positive correlation with peak LH values in the GnRH stimulation test. Pelvic ultrasonography is considered to be a useful test for estimating precocious puberty without causing much discomfort to the child.
目的:性早熟是指女孩在8岁前出现的肾上腺增生。促性腺激素释放激素刺激试验(Gonadotropin-releasing hormone stimulation test,简称GnRH刺激试验)广泛用于性早熟的诊断,常用于评估下丘脑-垂体-性腺轴的活性,但存在敏感性低、采血过程繁琐等缺点。另一方面,盆腔超声检查具有便宜和易于检测的优点。本研究的目的是探讨盆腔超声对性早熟的诊断价值,以及GnRH刺激试验与超声检查结果之间是否存在显著关系。方法:对2016年1月至2021年9月在顺天香大学首尔医院就诊的234例性早熟女童进行盆腔超声检查。结果:GnRH刺激试验中促黄体生成素(LH)峰值为10 IU/L及以上组双卵巢大小明显大于LH峰值小于7 IU/L组。GnRH刺激试验LH峰值≥10 IU/L组子宫尺寸分别比其他两组大0.63 cm和0.9 cm,差异有统计学意义。结论:GnRH刺激试验中,子宫和卵巢大小与LH峰值呈正相关。盆腔超声检查被认为是一个有用的测试,以估计性早熟,而不会引起太多的不适的孩子。
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引用次数: 0
Prognosis of Synchronous Double Primary Lung Cancer Based on Immunohistochemical Staining 基于免疫组化染色的同步双原发肺癌预后分析
Pub Date : 2022-06-30 DOI: 10.15746/sms.22.001
Y. Seok
Objective: This study evaluated the prognosis of strictly selected synchronous double primary lung cancer.Methods: The records of patients who underwent complete resection for synchronous double primary lung cancer were reviewed. Only patients who had different histologic types or the same histologies without nodal metastasis or different patterns of immunohistochemical staining were included. For survival analysis, the Kaplan-Meier method was used, and for comparison of the survival rate, a log-rank test was used.Results: Eighteen males and two females with a mean age of 67.0 years were included. Eight patients (40.0%) had the same histology and 12 patients (60.0%) had different histology in each tumor. Of the eight patients with the same histology, five had squamous cell carcinoma and three had adenocarcinoma, and the immunohistochemical staining results of all eight showed different patterns of p53 and epidermal growth factor receptor expression in each tumor. The median follow-up was 33.5 months (range, 6.1–102.3 months) for all patients and 41.6 months (range, 28.9–102.3 months) for the surviving patients. The 1- and 5-year overall survival rate and disease-free survival were 80.0% and 63.3%, and 70.0% and 33.3%, respectively. The 5-year overall and diseasefree survival of patients with identical and different histology was 56.3% and 31.3%, and 66.7% and 35.0%, respectively, which was no significant difference. There were no significant prognostic factors for overall survival and disease-free survival.Conclusion: The prognosis of synchronous double primary lung cancer was good in highly selected patients with any type of surgical resection. A large number of patients is needed for appropriate and standardized selection process.
目的:探讨严格筛选的同步双原发肺癌的预后。方法:对同期双原发肺癌行全切除术的病例进行回顾性分析。仅纳入不同组织学类型或相同组织学但无淋巴结转移或不同免疫组化染色模式的患者。生存率分析采用Kaplan-Meier法,生存率比较采用log-rank检验。结果:男性18例,女性2例,平均年龄67.0岁。组织学相同者8例(40.0%),不同者12例(60.0%)。在8例组织学相同的患者中,5例为鳞状细胞癌,3例为腺癌,8例患者的免疫组化染色结果均显示每种肿瘤中p53和表皮生长因子受体的表达模式不同。所有患者的中位随访时间为33.5个月(6.1-102.3个月),存活患者的中位随访时间为41.6个月(28.9-102.3个月)。1年、5年总生存率和无病生存率分别为80.0%、63.3%、70.0%、33.3%。相同和不同组织学患者的5年总生存率和无病生存率分别为56.3%和31.3%,66.7%和35.0%,差异无统计学意义。总生存期和无病生存期没有显著的预后因素。结论:高选择性的双原发肺癌患者,不论采用何种手术方式,预后均较好。适当和标准化的选择过程需要大量的患者。
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引用次数: 0
Comparison of Clinical Outcomes of Long Stent Implantation with First- and Second-Generation Drug-Eluting Stents Following Rotational Atherectomy 旋转动脉粥样硬化切除术后长支架植入与第一代和第二代药物洗脱支架的临床效果比较
Pub Date : 2022-06-30 DOI: 10.15746/sms.22.003
Dongeon Kim, Suyeong Park, I. Moon, M. Kong, Hyun-Woo Park, H. Choi, H. Seo, J. Suh, N. Lee, Y. Cho
Objective: Rotational atherectomy (RA) and newly developed second-generation drug-eluting stent (DES) support the strategy of longer stent deployment in comparison to short stent implantations in the past. However, studies analyzing the outcome of patients who received long stent implantation following RA are few in number. The present study compared the clinical outcomes of patients with the coronary arterial disease (CAD) who underwent RA with long stent implantation using first- and second-generation DES.Methods: A retrospective cohort study was performed at the single center from March 2003 to October 2019. Eighty-seven patients with CAD who underwent RA with ≥32 mm long stent implantation were enrolled in the study and divided into two groups according to the type of DES. As a primary endpoint, the cumulative 2-year incidence of major adverse cardiac events (MACE) including death, myocardial infarction (MI), target vessel revascularization, and stent thrombosis (ST) was compared by DES type. Adjusted interaction between the type of stent and clinical variables was estimated to determine the predictor variables of MACE.Results: The second-generation DES group was associated with a shorter procedure duration and more common usage of intravascular ultrasound in procedural characteristics. In the second-generation DES group, a trend toward a lower rate of MI and ST existed. All-cause mortality and cardiovascular mortality were not significantly different. When combined with MACE, we could identify a significant reduction in the second-generation DES group.Conclusion: In comparison to the first-generation DES group, the second-generation DES group was associated with a lower rate of MACE for 2 years in patients who underwent RA with long stent implantation.
目的:旋转动脉粥样硬化切除术(RA)和新开发的第二代药物洗脱支架(DES)与过去的短支架植入相比,支持更长的支架部署策略。然而,分析RA术后长期支架植入术患者预后的研究很少。本研究比较了第一代和第二代des对冠心病(CAD) RA患者行长支架植入术的临床结果。方法:2003年3月至2019年10月在单中心进行回顾性队列研究。87例CAD患者行RA≥32mm支架植入术,纳入研究,根据DES类型分为两组,以DES类型为主要终点,比较2年内主要心脏不良事件(MACE)的累计发生率,包括死亡、心肌梗死(MI)、靶血管重建术、支架血栓形成(ST)。评估支架类型与临床变量之间调整后的相互作用,以确定MACE的预测变量。结果:第二代DES组手术时间更短,手术特征中血管内超声的使用更普遍。在第二代DES组中,心肌梗死和ST发生率有降低的趋势。全因死亡率和心血管死亡率无显著差异。当与MACE联合使用时,我们可以发现第二代DES组显著减少。结论:与第一代DES组相比,第二代DES组在RA长支架植入术患者2年内MACE发生率较低。
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引用次数: 0
Relief of Symptoms by Early Administration of Infliximab in Patients with Suspected Spondyloarthritis: A Case Report 疑似脊椎关节炎患者早期应用英夫利昔单抗缓解症状1例报告
Pub Date : 2022-06-30 DOI: 10.15746/sms.22.016
Hyun Keun Lee, J. Chung
Low back pain is one of the most common musculoskeletal symptoms, and it can be difficult to make an accurate diagnosis based on symptoms alone. Osteitis condensans ilii (OCI) is one of the benign etiologies of low back pain and buttock pain mainly in young multiparous women. It can be diagnosed by radiological findings of the triangular sclerotic bone lesion, in the bilateral iliac bone of sacroiliac joints. Spondyloarthritis is a group of chronic inflammatory rheumatic diseases with common features, including axial and peripheral inflammatory arthritis, enthesitis, and an association with the human leukocyte antigen B27. Since both diseases may have similar clinical symptoms, the differential diagnosis may be difficult. We present a case of relief of symptoms by administration of infliximab in patients with suspected early spondyloarthritis that may be confused with OCI.
腰痛是最常见的肌肉骨骼症状之一,仅凭症状很难做出准确的诊断。髂骨凝聚性骨炎(OCI)是主要发生在年轻多产妇女的腰痛和臀部痛的良性病因之一。它可以通过骶髂关节双侧髂骨三角形硬化性病变的影像学表现来诊断。脊柱炎是一组具有共同特征的慢性炎性风湿病,包括轴性和外周性炎性关节炎、膝炎,并与人白细胞抗原B27相关。由于两种疾病可能有相似的临床症状,鉴别诊断可能很困难。我们提出了一个病例的缓解症状的管理英夫利昔单抗患者疑似早期脊柱炎,可能与OCI混淆。
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引用次数: 0
Necrotizing Gallbladder Torsion Masking as Acalculous Cholecystitis: A Review of Two Cases Treated with Successful Laparoscopic Cholecystectomy 坏死性胆囊扭转掩蔽为无结石性胆囊炎:腹腔镜胆囊切除术成功治疗2例回顾
Pub Date : 2022-06-30 DOI: 10.15746/sms.22.012
Hae Ill Jung
Gallbladder torsion is a rare disease and it is very difficult to diagnose preoperatively because the signs, symptoms, and image findings are very similar to the other cases of acute cholecystitis. However, in cases of gallbladder torsion, conservative treatments such as intravenous antibiotics and percutaneous cholecystostomy could be ineffective and result in even fatal. Hence, for urgent surgical management, gallbladder torsion must be considered especially in the elderly female patients with radiologic findings such as acalculous cholecystitis and a free-floating gallbladder. The author presents two cases of necrotizing gallbladder torsion in an elderly female patient who was treated successfully with laparoscopic cholecystectomy.
胆囊扭转是一种罕见的疾病,术前诊断非常困难,因为其体征、症状和图像表现与其他急性胆囊炎非常相似。然而,在胆囊扭转的情况下,保守治疗如静脉注射抗生素和经皮胆囊造瘘可能无效,甚至导致致命。因此,对于紧急手术治疗,必须考虑胆囊扭转,特别是在影像学表现为无结石性胆囊炎和自由浮动胆囊的老年女性患者中。作者提出两例坏死性胆囊扭转在一个老年女性患者谁是成功的治疗与腹腔镜胆囊切除术。
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引用次数: 0
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Soonchunhyang Medical Science
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