Colorectal cancer screening can be performed by fecal occult blood testing, sigmoidoscopy, double contrast barium enema or colonoscopy. Colonoscopy has the significant advantage that polyps can be removed during the s...Colorectal cancer screening can be performed by fecal occult blood testing, sigmoidoscopy, double contrast barium enema or colonoscopy. Colonoscopy has the significant advantage that polyps can be removed during the same procedure. Occasionally, colonoscopy can also reveal unexpected findings, including parasitic infections, even in asymptomatic patients. Tapeworms or cestodes are hermaphroditic parasites, which can live for considerable periods of time in the human gastrointestinal tract. Fish tapeworm (Diphyllobothrium species) are endemic in various parts of the world, the commonest species being Diphyllobothrium latum. Humans are the main definitive host for D. Latum and the majority of individuals harbouring the parasite are asymptomatic, while 40% of infected individuals may have low vitamin B12 levels. We describe a case of D. latum infection found on routine colonoscopic screening for colorectal cancer in an asymptomatic patient, which was successfully treated with praziquantel. The infection likely arose following raw fish (sushi) consumption.展开更多
HCV (hepatitis C virus) infection produces a chronic systemic disease that induces chronic hepatitis, cirrhosis and hepatocellular carcinoma, and also can induce dementia. Dementia can be defined as a syndrome of gl...HCV (hepatitis C virus) infection produces a chronic systemic disease that induces chronic hepatitis, cirrhosis and hepatocellular carcinoma, and also can induce dementia. Dementia can be defined as a syndrome of global and progressive impairment of acquired cognitive abilities. Importance of early detection of HCV infection in prevention of cognition decline in infected patients is emphasized along with the fast progressive form of dementia caused by HCV trough possible patogenetic mechanismas presented in this paper.展开更多
The treatment of metastic melanoma has rapidly evolved in the last 5 years, giving clinicians and patients the hope for long lasting responses. In the field of modern immunotherapy, we are reaching the point of an exp...The treatment of metastic melanoma has rapidly evolved in the last 5 years, giving clinicians and patients the hope for long lasting responses. In the field of modern immunotherapy, we are reaching the point of an expressive percentage of patients achieving long term survival with anti-CTLA4 and anti-PD1 checkpoint inhibitors. Of note, there is a considerable amount of patients excluded from the checkpoint blockade trials because of comorbidities like chronic viral infections. A precaution to avoid autoimmune induced hepatitis rendered HBV (hepatitis B virus) and HCV (hepatitis C virus) infected patients usually ineligible, but real life data in those patients, who are getting treatment despite of that, is pointing toward the feasibility and safety of immunotherapy in this context. To ilustrate that, we report the case of a metastatic non-BRAF mutated melanoma patient with HCV chronic infection and a surprising benefit derived from ipilimumab and pembrolizumab for his latter condition.展开更多
Abstract: Long bone septic non-union by MRSA (methicillin-resistant Staphylococcus aureus) is always a challenge for the orthopaedic society. Traditional treatment options include distraction osteogenesis methods a...Abstract: Long bone septic non-union by MRSA (methicillin-resistant Staphylococcus aureus) is always a challenge for the orthopaedic society. Traditional treatment options include distraction osteogenesis methods and vascularised bone grafting. These techniques require a high level of expertise and are frequently involved with a variety of side effects or complications. We present a rare case of ulnar fracture complicated by MRSA infection that led to septic non-union. We treated the septic non union with the technique of induced membrane formation (Masquelet technique). A 33 year old male presented to the outpatient clinic, 2 months after internal fixation of a Gustillo I fracture of the left forearm. There was pus discharge from the operative wound and specimen culture was positive for MRSA. Initially the patient received conservative treatment with antibiotics for a period of one month. However, the patient returned with the same clinical presentation. The patient was then treated with hardware removal of the ulna and debridement of the septic non-union. The formed 5 cm bone defect was filled with cement spacer and the ulnar bone was fixed with external fixation. Eight weeks later, the spacer was removed and the bone gap was filled with autologous cancellous bone graft from iliac crest. Five months after grafting, the patient was reviewed. No clinical or functional problems were noted and osseous consolidation of the ulnar bone was confirmed in plain x-rays. The Masquelet technique is a promising alternative treatment for the management of infected long bone non-unions of the upper extremity.展开更多
The Mycoplasma hominis infection is a rare postoperative complication after joint replacement. Based on our knowledge, there were only two cases reported by Korea all over the world currently. A case of postoperative ...The Mycoplasma hominis infection is a rare postoperative complication after joint replacement. Based on our knowledge, there were only two cases reported by Korea all over the world currently. A case of postoperative Mycoplasma hominis infection after total knee replacement in our hospital was reported in this article. It was confirmed through mass spectrometer and Mycoplasma cultivation and treated by the first stage debridement, polyethylene insert replacement, and then drainage and irrigation combined with sensitive antibiotics after the operation. We observed that the C reactive protein (CRP) level correlates with the development of disease, while the erythrocyte sedimentation rate (ESR) remains at a high level, indicating the relevance between the Mycoplasma hominis infection caused by knee joint replacement and CRP. This study aims to report the case and review relevant literature.展开更多
文摘Colorectal cancer screening can be performed by fecal occult blood testing, sigmoidoscopy, double contrast barium enema or colonoscopy. Colonoscopy has the significant advantage that polyps can be removed during the same procedure. Occasionally, colonoscopy can also reveal unexpected findings, including parasitic infections, even in asymptomatic patients. Tapeworms or cestodes are hermaphroditic parasites, which can live for considerable periods of time in the human gastrointestinal tract. Fish tapeworm (Diphyllobothrium species) are endemic in various parts of the world, the commonest species being Diphyllobothrium latum. Humans are the main definitive host for D. Latum and the majority of individuals harbouring the parasite are asymptomatic, while 40% of infected individuals may have low vitamin B12 levels. We describe a case of D. latum infection found on routine colonoscopic screening for colorectal cancer in an asymptomatic patient, which was successfully treated with praziquantel. The infection likely arose following raw fish (sushi) consumption.
文摘HCV (hepatitis C virus) infection produces a chronic systemic disease that induces chronic hepatitis, cirrhosis and hepatocellular carcinoma, and also can induce dementia. Dementia can be defined as a syndrome of global and progressive impairment of acquired cognitive abilities. Importance of early detection of HCV infection in prevention of cognition decline in infected patients is emphasized along with the fast progressive form of dementia caused by HCV trough possible patogenetic mechanismas presented in this paper.
文摘The treatment of metastic melanoma has rapidly evolved in the last 5 years, giving clinicians and patients the hope for long lasting responses. In the field of modern immunotherapy, we are reaching the point of an expressive percentage of patients achieving long term survival with anti-CTLA4 and anti-PD1 checkpoint inhibitors. Of note, there is a considerable amount of patients excluded from the checkpoint blockade trials because of comorbidities like chronic viral infections. A precaution to avoid autoimmune induced hepatitis rendered HBV (hepatitis B virus) and HCV (hepatitis C virus) infected patients usually ineligible, but real life data in those patients, who are getting treatment despite of that, is pointing toward the feasibility and safety of immunotherapy in this context. To ilustrate that, we report the case of a metastatic non-BRAF mutated melanoma patient with HCV chronic infection and a surprising benefit derived from ipilimumab and pembrolizumab for his latter condition.
文摘Abstract: Long bone septic non-union by MRSA (methicillin-resistant Staphylococcus aureus) is always a challenge for the orthopaedic society. Traditional treatment options include distraction osteogenesis methods and vascularised bone grafting. These techniques require a high level of expertise and are frequently involved with a variety of side effects or complications. We present a rare case of ulnar fracture complicated by MRSA infection that led to septic non-union. We treated the septic non union with the technique of induced membrane formation (Masquelet technique). A 33 year old male presented to the outpatient clinic, 2 months after internal fixation of a Gustillo I fracture of the left forearm. There was pus discharge from the operative wound and specimen culture was positive for MRSA. Initially the patient received conservative treatment with antibiotics for a period of one month. However, the patient returned with the same clinical presentation. The patient was then treated with hardware removal of the ulna and debridement of the septic non-union. The formed 5 cm bone defect was filled with cement spacer and the ulnar bone was fixed with external fixation. Eight weeks later, the spacer was removed and the bone gap was filled with autologous cancellous bone graft from iliac crest. Five months after grafting, the patient was reviewed. No clinical or functional problems were noted and osseous consolidation of the ulnar bone was confirmed in plain x-rays. The Masquelet technique is a promising alternative treatment for the management of infected long bone non-unions of the upper extremity.
文摘The Mycoplasma hominis infection is a rare postoperative complication after joint replacement. Based on our knowledge, there were only two cases reported by Korea all over the world currently. A case of postoperative Mycoplasma hominis infection after total knee replacement in our hospital was reported in this article. It was confirmed through mass spectrometer and Mycoplasma cultivation and treated by the first stage debridement, polyethylene insert replacement, and then drainage and irrigation combined with sensitive antibiotics after the operation. We observed that the C reactive protein (CRP) level correlates with the development of disease, while the erythrocyte sedimentation rate (ESR) remains at a high level, indicating the relevance between the Mycoplasma hominis infection caused by knee joint replacement and CRP. This study aims to report the case and review relevant literature.