A case of hepatopleural fistula complicated by transcatheter arterial chemoembolization for hepatocellular carcinoma with liver abscess / 대한내과학회지

Pleural complication is extremely rare among the complications of lung following transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma. We report a case of hepatopleural fistula complicated by TACE. A 50-year-old male was admitted to the hospital because of aggravation of cough and chest pain. Fifty five days before admission, a liver abscess had developed and treated by percutaneous drainage. A hepatocellular carcinoma had been diagnosed as a cause of liver abscess. Forty five days before admission, TACE had been performed for the hepatocellular carcinoma. Thirty days after TACE, dry cough and right pleuritic chest pain developed. After admission, serial CT scans of thorax and abdomen showed the pleural effusion containing the lipiodol from the liver through hepatopleural fistula. Chest tube insertion with a urokinase instillation was performed for the treatment of empyema caused by hepatopleural fistula.

A Case of Gastric Mucormycosis Associated with Diabetes Mellitus and Alcoholic Hepatitis / 대한소화기내시경학회지

Mucormycosis is a rare, fulminating, opportunistic fungal infection that occurs almost exclusively in immunocompromised hosts such as patients with diabetes, leukemia, lymphoma. These fungi are ubiquitous in nature, and can be found on decaying vegetation and in the soil. So they are relatively frequent contaminants in the clinical microbiology laboratory. Recently the incidence of mucormycosis is rising associated with the increasing use of immunosuppressive agents, antibiotics. Though mucormycosis is frequently fatal, there has been a significant improvement in the outcome by early diagnosis and aggressive treatment. Mucormycosis can be categorized as rhinocerebral, pulmonary, gastrointestinal, cutaneous, widely disseminated and miscellaneous; gastro-intestinal involvement is extremely rare. We report a patient with gastric mucormycosis who had diabetes mellitus and alcoholic hepatitis. His chief complaint was an epigastric pain, and the gastroscopy showed huge multiple ulcers, coated with exudates. The histologic examination revealed multiple broad, nonseptate hyphae with right angle branchings, diagnosed as mucormycosis.

Effects of pretreatment of serotonin synthesis inhibitor p-chlorophenylalanine on lipopolysaccharide-induced anorexia in rats

In the present study, we investigated the effect of pretreatment of p-chlorophenylalanine (PCPA), inhibitor of serotonin synthesis, on lipopolysaccharide (LPS)-induced anorexia in rats. First of all, effects of PCPA injection on food intake and body weight in rats were investigated. During 4 days of PCPA injection (300 mg/kg BW once a day), food intake was decreased by 33% and daily gain in body weight was inhibited compared with controls. Twenty-four hours after last PCPA injection, food intake and gain in body weight returned toward almost normal. Pair-feeding to PCPA (PCPAP) injection revealed that body weight of rats in PCPA group was not different from rats in PCPAP groups. To quantify the effects of LPS on food intake and body weight, we administered varying doses (10, 100, 500 microgram/kg BW) of LPS to rats. LPS induced a reduction of food intake and weight loss in a dose dependent manner compared with controls. To evaluate the effects of PCPA pretreatment on LPS injection, rats were treated with PCPA for 4 days (300 mg/kg BW once a day), which was followed by LPS injection for 2 days (500 microgram/kg BW once a day) (PCPA+LPS group), while rats in LPS group had injections with normal saline instead of PCPA for 4 days, which was followed by LPS administration. Rats in control group received 0.9% NaCl for 6 days. LPS decreased food intake by 80% and inhibited gain in body weight, while PCPA pretreated rats showed normalized food intake and gain in weight during the days of LPS injections compared with controls. In conclusion, pretreatment of PCPA prevented LPS-induced anorexia.