Esophageal rupture worsened after chest tube insertion in an esophageal rupture patient who presented with pneumothorax

Spontaneous rupture of the esophagus wall is a rare, life-threatening condition, and the diagnosis of esophageal rupture is challenging as history and symptoms can be nonspecific. In some cases, chest radiography can reveal pneumothorax. We report a case of aggravated esophageal rupture after chest tube intubation in an esophageal rupture patient with pneumothorax. Interventionists should be aware that esophageal rupture may present as pneumothorax and that chest tube insertion can exacerbate esophageal rupture.

Consideration on the role of the regional oral care center for persons with disabilities and the appropriate role of specialized dental hygienists / 대한구강보건학회지

Objectives@#This study aims to define the role of the local dental clinic for people with disabilities and the appropriate role of the dental hygienist to resolve oral health inequality with people with disabilities. @*Methods@#From September 12, 2022 to November 11, 2022, 16 experts who voluntarily participated in the research, among the experts recommended by the related institutes, were selected through stratification analysis. The results of this study and improvement plans are as follows. @*Results@#First, as a result of measuring the importance of the role of a regional oral care center for people with disabilities in the analytic hierarchy process (AHP) middle category, check-up was found to be the most important (0.364, C.I=0.01). For examination, a facility visit checkup and regular checkups were required. Second, as a result of measuring the importance of the role of a dedicated dental hygienist in the AHP middle category, the institutional-linked activity was found to be the most important (0.417, C.I=0.02). As for institutional-linked activities, linkage with local community organizations, patient management, and public relations activities were required. @*Conclusions@#Considering these results, the role of a regional oral care center for people with disabilities is to perform examinations and preventive treatments, primary treatments (simple), education and counseling, and establish a smooth medical return system to serve as a base for dental treatment for people with disabilities. Education and counseling are provided through professional patient response and the arrangement of a dedicated dental hygienist, and oral health care is provided to people with disabilities through professional treatment assistance for patients and treatment support and screening, linkage with local community institutions, and patient management. Specialized dental hygienists should play a role in supporting the operation of oral health care for people with disabilities.

Oral malodor prevention effect of toothpaste containing 0.5% zinc citrate and 1,450 ppm fluoride / 대한구강보건학회지

Objectives@#This study aims to verify the effect of the use of a toothpaste containing 0.5% zinc citrate and 1,450 ppm fluoride on oral malodor. @*Methods@#In this study, the experimental group using the experimental toothpaste and the control group using the standard toothpaste control toothpaste were allowed to use each toothpaste for 4 weeks and then a clinical test to measure the change in bad breath was conducted. A study was conducted to evaluate the reduction effect. Efficacy was evaluated by conducting BB checker test and Oralchroma test three times in total before the testing 2 weeks and 4 weeks after the test. @*Results@#As a result of measuring the degree of bad breath using the BB checker, before the start of the test, the experimental group was 46.3 and the control group was 47.2. After 2 weeks of the test, the experimental group was 38.5 and the control group was 44.2 and after 4 weeks the experimental group was 29.6 and the control group was 39.2. There was a significant difference between the experimental group and the control group after 4 weeks of the test (P<0.05). The volatile sulfur compounds measured by Oralchroma were 0.825 ng/10 ml for the experimental group and 0.819 ng/10 ml for the control group after 2 weeks of the test, and they were 0.705 ng/10 ml for the experimental group and 0.860 ng/10ml for the control group after 4 weeks of the test. It was confirmed that a significant index change appeared after 4 weeks of the test compared to before the test (P<0.05). @*Conclusions@#It was confirmed that an improved effect of removing bad breath can be expected when a toothpaste containing 0.5% zinc citrate and 1,450 ppm fluoride is used.

Superoxide Dismutase Gene (SOD1, SOD2, and SOD3) Polymorphisms and Antituberculosis Drug-induced Hepatitis

PURPOSE: Drug-induced liver injury (DILI) is a serious issue often leading to discontinuation of the proper regimen of antituberculosis drugs (ATD). Previous studies have suggested that antioxidant enzymes play an important role in DILI. METHODS: We explored whether polymorphisms in superoxide dismutase genes, including Cu/Zn superoxide dismutase (SOD1), manganese superoxide dismutase (SOD2) and extracellular superoxide dismutase (SOD3) are associated with ATD-induced hepatitis. Genotype distributions of four single nucleotide polymorphisms (SNPs) in three genes (rs2070424, SOD1; rs4880, SOD2; rs2536512, and rs1799895, SOD3) were compared between 84 patients with ATD-induced hepatitis and 237 patients tolerant to ATD. RESULTS: Intron SNP rs2070424 of SOD1 showed a significant association with ATD-induced hepatitis. The frequency of genotypes carrying minor alleles (GA or GG) was significantly higher in the case group than that of controls (P=0.019, OR=2.26, 95% CI 1.14-4.49). For the other SNPs of SOD2 and SOD3, there were no differences in genotype frequencies between ATD-induced hepatitis and ATD-tolerant controls. CONCLUSIONS: These findings suggest that rs2070424 of SOD1 is significantly associated with ATD-induced hepatitis. This genetic variant may be a risk factor for ATD-induced hepatitis in individuals from Korea.

Tuberculous Peritonitis Mimicking Primary Peritoneal Carcinoma

Tuberculous peritonitis is one of the most common extrapulmonary tuberculosis. The presenting signs and symptoms, together with the carbohydrate antigen (CA) 125 status and imaging findings may resemble the primary peritoneal carcinoma or ovarian carcinoma. We herein report a case on a 71-year-old woman who is presented with abdominal distension, abdominal pain, nausea, anorexia. Abdomino-pelvic computed tomography scans reveal large amounts of ascites and mottled omentum with diffuse nodular masses, and the serum CA 125 level is elevated. The initial clinical diagnosis is the primary peritoneal carcinoma, but the final histological diagnosis confirms the tuberculous peritonitis. Thus, we discuss the differential diagnosis of tuberculous peritonitis from primary peritoneal carcinoma and also the problems especially found in old aged patients. In conclusion, although the elderly patients are suspected with malignancy, we should keep in mind the possibility of curable diseases and perform laparoscopic biopsy during the early stage aggressively.

Malignant Perivascular Epithelioid Cell Tumor (PEComa) Arising in the Omentum with Metastatic Peritoneal Seeding: A Case Report / 대한내과학회지

The World Health Organization (WHO) defines a perivascular epithelioid cell tumor (PEComa) as a mesenchymal neoplasia composed of perivascular epithelioid cells with characteristic morphological and immunohistochemical features. They are rarely malignant. Indeed, only a few cases have been reported in the English literature, and this is the first case of PEComa reported in Korea. A 64-year-old man presented with an abdominal mass and peritoneal seeding. The patient underwent mass excision with descending colon resection and anastomosis. The primary mass and peritoneal seeding was diagnosed as a PEComa histopathologically. Seven months later, he developed liver metastasis and aggravated peritoneal seeding. Here, we report a case of malignant PEComa of the omentum.

A Case of Bronchial Artery Aneurysm in Cavitary Pulmonary Tuberculosis / 대한내과학회지

A bronchial artery (BA) aneurysm is a rare, life-threatening disease when it ruptures. Recently, we experienced a case of massive hemoptysis due to a BA aneurysm rupture in a pulmonary tuberculosis cavity, treated with BA embolization followed by surgical resection of the cavitary lesion. To our knowledge, this is the first case of a BA aneurysm associated with cavitary pulmonary tuberculosis.

A Case of Bronchial Artery Aneurysm in Cavitary Pulmonary Tuberculosis / 대한내과학회지

A bronchial artery (BA) aneurysm is a rare, life-threatening disease when it ruptures. Recently, we experienced a case of massive hemoptysis due to a BA aneurysm rupture in a pulmonary tuberculosis cavity, treated with BA embolization followed by surgical resection of the cavitary lesion. To our knowledge, this is the first case of a BA aneurysm associated with cavitary pulmonary tuberculosis.

A Case of a Huge Biliary Bezoar Treated with ESWL / 대한췌담도학회지

A bezoar is a mass formed by the accumulation of digested food. A biliary bezoar, namely a bezoar formed in the bile duct, is rare, which occurs mostly in patients who formerly underwent cholecystectomy. It appears that incompetent sphincter produces occasional reverse flow of foreign bodies including undigested food from the alimentary canal into the bile tract. Surgical treatment is used for huge biliary bezoar which is too huge to be removed by nonsurgical treatment. Extracorporeal shock wave lithotripsy (ESWL) is mostly used to fragment renal or urinary calculi, but may be sparingly used against biliary calculi. This is to report the rare case of a patient with biliary bezoar who formerly underwent open cholecystectomy and choledocoduodenostomy. The patient's huge biliary bezoar was removed by ESWL and the successive execution of endoscopic retrograde cholangio pancreatography (ERCP). ESWL is expected to be a comparatively safe and convenient solution to huge biliary bezoars.