[Show abstract][Hide abstract] ABSTRACT: Riedel's thyroiditis (RT) is a rare chronic inflammatory disease of the thyroid gland. It is characterized by a fibroinflammatory process that partially destroys the gland and extends into adjacent neck structures. Its clinical manifestation can mask an accompanying thyroid neoplasm and can mimic invasive thyroid carcinoma. Therefore, diagnosis can be difficult prior to surgical removal of the thyroid, and histopathologic examination of the thyroid is necessary for a definite diagnosis. The concurrent presence of RT and other thyroid diseases has been reported. However, to our knowledge, the association of RT with acute suppurative thyroiditis and micropapillary carcinoma has not been reported. We report a rare case of concurrent RT, acute suppurative thyroiditis, and micropapillary carcinoma in a 48-year-old patient.
The Korean Journal of Internal Medicine 03/2013; 28(2):236-41. DOI:10.3904/kjim.2013.28.2.236
[Show abstract][Hide abstract] ABSTRACT: BACKGROUND: Choledocholithiasis commonly occurs in patients with symptomatic cholelithiasis. Although the recently developed multidetector computed tomography (MDCT) scan enhances the ability to diagnose choledocholithiasis, this technique is considered to have some limitations for evaluating the common bile duct (CBD). AIM: The purpose of this study was to evaluate the necessity for performing endoscopic ultrasound (EUS) as an add-on test to detect choledocholithiasis in patients who were diagnosed with gallstone disease without choledocholithiasis based on MDCT. METHODS: Three hundred twenty patients with gallstone disease and no evidence of CBD stones according to MDCT underwent EUS between March 2006 and April 2011. If CBD stones were suspected based on the EUS results or clinical symptoms, a final diagnosis was obtained by endoscopic retrograde cholangiopancreatography (ERCP). The patients' medical records were retrospectively analyzed based on clinical symptoms, biochemical findings, and results of the imaging studies. RESULTS: CBD stones were not detected with MDCT in 41 (12.8 %) out of 320 patients with gallstone disease. The causes for these discrepancies could be attributed to small stone size (n = 19, 46.3 %), isodensity (n = 18, 43.9 %), impacted stones (n = 1, 2.4 %), and misdiagnosis (n = 3, 7.3 %). If EUS were used as a triage tool, unnecessary diagnostic ERCP and its complications could be avoided for 245 (76.6 %) patients. CONCLUSIONS: MDCT may not be a primary technique for detecting CBD stones. EUS should be performed instead as an add-on test to evaluate the CBD for patients with gallstone-related disease. In particular, EUS should be routinely recommended for patients with abnormal liver enzyme levels, pancreatitis, and dilated CBD.
[Show abstract][Hide abstract] ABSTRACT: Diabetes insipidus is a disorder caused by complete or partial deficiency or unresponsiveness to antidiuretic hormone. Both diabetes mellitus and diabetes insipidus are well-known causes of polyuria and polydipsia. Although Wolfram Syndrome, which is characterized by the concurrence of diabetes mellitus and diabetes insipidus along with optic atrophy and ataxia, is frequently reported, the concurrence of diabetes insipidus and type 2 diabetes mellitus without optic atrophy and deafness is rare. We report a 31-year-old woman presenting with hyperglycemic hyperosmolar syndrome caused by type 2 diabetes mellitus complicated with concurrent central diabetes insipidus.
[Show abstract][Hide abstract] ABSTRACT: Emphysematous infections of the abdomen are potentially life-threatening conditions that require aggressive medical and surgical management. Emphysematous pancreatitis is an uncommon disease that presents as acute pancreatitis with intra-parenchymal gas at the time of diagnosis. Traditionally, emphysematous pancreatitis is an indication for surgical intervention. However, a few cases of emphysematous pancreatitis, managed successfully without surgical debridement have been reported. We present a case of emphysematous pancreatitis managed medically without surgical debridement in a 56-year-old male.
[Show abstract][Hide abstract] ABSTRACT: To determine whether female smokers are more or less susceptible to the detrimental pulmonary-function effects of smoking when compared to male smokers among patients with lung cancer.
Pack-years and pulmonary function indices were compared between 1,594 men and women with lung cancer who were smokers or had a history of smoking. Differences in individual susceptibility to smoking were estimated using a susceptibility index formula.
Of the patients, 959 (92.8%) men and 74 (7.2%) women were current smokers. Common histological types of lung cancer were squamous cell carcinoma, adenocarcinoma, and small cell carcinoma, among others. Women had a lower number of pack-years, forced expiratory volume in 1 second (FEV(1), liters), forced vital capacity (FVC, liters), and total lung capacity (TLC, liters) compared to those of men (25.0 ± 19.2 vs. 42.9 ± 21.7 for pack-years; 1.4 ± 0.5 vs. 2.0 ± 0.6 for FEV(1); 3.0 ± 0.7 vs. 2.0 ± 0.6 for FVC; 4.5 ± 0.8 vs. 5.7 ± 1.0 for TLC; all p < 0.001). The susceptibility index for women was significantly higher compared to that of men (1.1 ± 4.1 vs. 0.7 ± 1.1; p = 0.001). A significant inverse association was shown between the susceptibility index and TLC and FVC (r = -0.200 for TLC, -0.273 for FVC; all p < 0.001).
The results suggest that the detrimental effects of smoking on pulmonary function are greater in women, as compared to those in men, among patients with lung cancer.
The Korean Journal of Internal Medicine 12/2011; 26(4):427-31. DOI:10.3904/kjim.2011.26.4.427
[Show abstract][Hide abstract] ABSTRACT: The world encountered the global outbreak of an H1N1 influenza pandemic in 2009. Influenza has accounted for grave outcomes, not only through infectious complications, but also through the exacerbation of underlying chronic diseases. A substantial number of confirmed or probable cases of influenza had been reported during the 2009 H1N1 pandemic in South Korea, but a review of the development of influenza-related complications or the exacerbation of underlying chronic diseases has been absent. This study aims to understand the influence of the 2009 pandemic on the exacerbation of existing cardiopulmonary diseases.