A Case of Corrosive Gastritis Caused by Salt-fermented Northern Sand Lance / 대한소화기내시경학회지

We experienced a case of an 18-year-old woman who ingested salt-fermented northern sand lance and developed corrosive gastritis. The patient underwent a esophagogastroscopy and had developed a deep ulceration in the antrum. This cases shows that salt-fermented northern sand lance, which is very acidic and includes various biogenic amines, has the possibility of inducing a corrosive injury to the stomach.

A Case of Gastritis Cystica Profunda Presenting with a Submucosal Cystic Tumor / 대한소화기내시경학회지

Gastritis cystica profunda (GCP) is a lesion characterized by elongation of the gastric foveolae with hyperplasia and cystic dilatation of the gastric glands that extends into the submucosal layer. In most cases, gastritis cystica profunda develops in patients who have undergone a gastroenterostomy, with or without gastric resection. GCP may present not only as a submucosal tumor or as solitary or diffuse polyps, but GCP is also rarely seen as a giant gastric mucosal fold. A patient arrived at our hospital with dyspepsia. Gastroduodenoscopy (EGD) showed the presence of a submucosal tumor measuring 3 cm in the widest diameter in the body of the stomach. A CT scan demonstrated the cystic nature of the lesion and endoscopic ultrasound (EUS) depicted a homogeneous hypoechoic, unilocular cystic mass without any internal solid component. EGD, CT and EUS findings suggested that the lesion was more likely to be benign than malignant. The lesion was treated with an endoscopic mucosal resection (EMR), and the lesion was finally diagnosed as gastritis cystica profunda. A follow-up EGD demonstrated that all mucosal surfaces were well healed four weeks after the EMR.

A Case of Chronic Acalculous Cholecystitis Diagnosed by Delayed Contrast Emptying in Gallbladder / 대한소화기학회지

Chronic acalculous cholecystitis is a diagnosis of exclusion in patients complaining acalculous biliary pain. The possible causes of acalculous biliary pain are chronic gallbladder (GB) inflammation, GB dysfunction, cholesterolosis, cystic duct stenosis or microlithiasis. Recently, laparoscopic cholecystectomy is the choice of treatment for acalculous biliary pain. We experienced a 32-year-old woman whose initial symptoms were right upper quadrant pain and nausea only. The abdominal computed tomography, DISIDA scan, and upper and lower endoscopic examinations were nonspecific. Up to 48 hours after endoscopic retrograde cholangiopancreatography, contrast emptying of GB was delayed, implying dysfunctional GB. As the patient's right upper quadrant pain and tenderness became aggravated, the laparoscopic cholecystectomy was done and the final diagnosis of chronic acalculous cholecystitis was confirmed.

Comparison between Immunostimulatory Activity and Molecular Structure of Different Polysaccharides

BACKGROUND: We previously reported that ginsan, a polysaccharide extracted from Panax ginseng had an immunostimulatory activity such as mitogenic activity, activation of macrophages and killer cells, and production of a variety of cytokines which resulted in antitumor and antiseptic effects. We further purified alpha-(1-->6)-glucan and beta-(2-->6)-fructan from the ginsan with size exclusion and ion-exchange column chromatography successively. In this study, we performed the structure-based activity of ginsan by comparison with known polysacchrides such as beta-glucan, curdlan, laminarin, levan, dextran, lentinan and OK-432. METHODS: To investigate the immunostimulatory activity of several polysaccharide compounds, we investigated the stimulation of lymphocytes proliferation, the generation of activated killer cells and the secretion of nitrites from activated macrophages. RESULTS: Of polysaccharides tested, curdlan and ginsan stimulated lymphocyte proliferation, suggesting that the molecular weight and composition of polysaccharide are dependent on the mitogenic activity. The production of nitric oxide was significantly increased in curdlan, levan, ginsan and its fraction, indicating that fructan has also capacity to activate macrophages and may devote to kill pathogens. In addition, the activation of macrophages was seemed to be independent of molecular weight of polysaccharide. The generation of AK cells was exhibited in order of curdlan, OK-432> F1, ginsan, F3>levan>etc. The AK activity may be dependent on molecular weight and composition of polysaccharides. CONCLUSION: Unfortunately, purified polysaccharide from ginsan were less active on immunostimulatory activity than mixed compounds of polysaccharides. From the viewpoint of structure and activity relationships, we found several characteristic features.

Unresolving Pneumonia / 결핵및호흡기질환

A 47-year-old-man was admitted to the emergency department with dyspnea, right pleuritic pain, and high fevers for 3 days. He had a nonproductive cough that exacerbated the chest pain. A clinical examination revealed distressed and slightly tachypneic patient, with blood pressure of 110/90 mmHg, temperature of 39degrees C, pulse of 90 beats/min, respiratory rate of 24 breaths/min. A chest examination showed significantly diminished breath sounds in the right lung with dullness to percussion. Laboratory investigation demonstrated leukocytosis and a raised C-reactive protein. The results of arterial blood gas analysis revealed moderate hypoxemia. A radiograph and a CT scan of the chest showed extensive consolidation with multifocal low densities, and pleural effusion in the right lung. A diagnostic thoracentesis revealed straw-colored fluid, which was found to be a neutrophil-predominant exudate. At 7 days after admission, the clinical symptoms had not improved and the temperature was still 39degrees C despite the aggressive therapy of community- acquired pneumonia. After comprehensive history taking, we realized then that he accidentally aspirated kerosene while siphoning from fuel tank to put into the boiler 3 days ago. Bronchoscopy with bronchial washings could be successful in establishing the diagnosis of hydrocarbon pneumonitis by demonstration of a high lipid-laden macrophage index. Thereafter, the symptoms and radiographic opacities gradually improved, and he was discharged several days later.

Necrotizing Pneumonia Complicated by Streptococcus Pyogenes Bacteremia in Patient with COPD / 결핵

No abstract available.

A Measles Outbreak Among Adults in Daejeon City, 2001 / 감염과화학요법

BACKGROUND: Measles is a highly infectious disease throughout the world and has not yet been eradicated with aggressive vaccination in Korea since 1960's. Recently, measles outbreaks have occurred periodically every 2 to 4 years. Unlike measles in children, few clinical studies on the measles of adult in our domestic area were carried out. In this study, we analyzed epidemiologic and clinical features of adult measles patients. METHODS: From January to June in 2001, 23 adult measles patients were admitted in Sun general hospital in Daejeon. Epidemiologic findings, clinical course, and laboratory findings were reviewed retrospectively. RESULTS: Measles was predominant in male patients (M : F=2.3 : 1). Many of the patients were late teenagers and early twenties. Major symptoms were fever (100%), cough (100%), rash (100%), diarrhea (69.6%), vomiting (60.9%), headache (60.9%), rhinorrhea (30.4%), and sore throat (30.4%). Koplik spot was observed in 11 (47.8%) patients. Rash appeared 1-6 days after the onset of fever. Fever lasted for 5-9 days and cough lasted for 10-14 days. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were elevated in 12 (52.2%) and 9 (39.1%) patients, respectively. Only 14 (60.9%) patients were seropositive for measles specific IgG antibody, but all the patients were seropositive for measles specific IgM antibody. No fatal complication was observed. CONCLUSION: Gastrointestinal symptom and hepatic dysfunction were the clinical characteristics of adult measles outbreak in Daejeon, 2001. Different from previous studies, all patients were seropositive for measles specific IgM antibody.

A Measles Outbreak Among Adults in Daejeon City, 2001 / 감염과화학요법

BACKGROUND: Measles is a highly infectious disease throughout the world and has not yet been eradicated with aggressive vaccination in Korea since 1960's. Recently, measles outbreaks have occurred periodically every 2 to 4 years. Unlike measles in children, few clinical studies on the measles of adult in our domestic area were carried out. In this study, we analyzed epidemiologic and clinical features of adult measles patients. METHODS: From January to June in 2001, 23 adult measles patients were admitted in Sun general hospital in Daejeon. Epidemiologic findings, clinical course, and laboratory findings were reviewed retrospectively. RESULTS: Measles was predominant in male patients (M : F=2.3 : 1). Many of the patients were late teenagers and early twenties. Major symptoms were fever (100%), cough (100%), rash (100%), diarrhea (69.6%), vomiting (60.9%), headache (60.9%), rhinorrhea (30.4%), and sore throat (30.4%). Koplik spot was observed in 11 (47.8%) patients. Rash appeared 1-6 days after the onset of fever. Fever lasted for 5-9 days and cough lasted for 10-14 days. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were elevated in 12 (52.2%) and 9 (39.1%) patients, respectively. Only 14 (60.9%) patients were seropositive for measles specific IgG antibody, but all the patients were seropositive for measles specific IgM antibody. No fatal complication was observed. CONCLUSION: Gastrointestinal symptom and hepatic dysfunction were the clinical characteristics of adult measles outbreak in Daejeon, 2001. Different from previous studies, all patients were seropositive for measles specific IgM antibody.

A Case of Pulmonary Carcinosarcoma with Persistent Mild Fever

Carcinosarcoma is defined as a malignant tumor with an admixture of carcinoma and sarcoma. Pulmonary carcinosarcoma accounts for about 0.27 percent of all lung neoplasms. It occurs frequently in males, particularly in smokers between 50 and 80 years of age. Preoperative diagnostic tests, such as sputum cytology, percutaneous fine needle biopsy and bronchoscopy, have a low yield in detection of pulmonary carcinosarcoma. The diagnosis is verified by postoperative pathologic findings and by immunohistochemical investigations in many cases. Surgical resection is the treatment of choice. As the metastasis to regional lymph nodes and distant organ is common at diagnosed time, the prognosis is quite poor. We report a case of pulmonary carcinosarcoma presented with persistent mild fever and blood-tinged sputum in a 66-year-old male.

A Case of Synchronous Primary Right Atrial Myxoma and Occult Hepatocellular Carcinoma

The incidence of cardiac metastasis of hepatocellular carcinoma (HCC) is about 1-4% and especially metastasis to right atrium (RA) is very rare, with an incidence of only 0.7-3% in a postmortem series. But, most RA tumors associated with HCC are intracardiac metastasis and the occurrence of synchronous primary RA myxoma and HCC is extremely rare. We report one case that a cardiac mass was primary RA myxoma initially misdiagnosed as occult HCC with intracardiac metastasis.

Quantitative Evaluation of Dysphagia Using Scintigraphy

OBJECTIVE: To investigate the clinical usefulness of scintigraphy for the evaluation of dysphagia in patients with brain lesion and to clarify the most useful quantitative parameter for detection of aspiration using scintigraphy. METHOD: For 42 patients with dysphagia, swallowing evaluations were done by videofluoroscopy and scintigraphy. According to videofluoroscopic findings these patients were grouped into three; aspiration, laryngeal penetration and no penetration group. Quantitative parameters from scintigraphy were measured and compared among three patients groups and normal control; these parameters were oral discharge time (ODT), pharyngeal transit time (PTT), oral residue (OR), pharyngeal residue (PR), pharyngeal swallowing efficiency (PSE) and oro-pharyngeal swallowing efficiency (OPSE). Sensitivity and specificity of these parameters detecting aspiration were also evaluated according to the videofluoroscopic findings. RESULTS: In aspiration group ODT, PTT, PSE and OPSE were 1.18+/-1.14 sec, 1.80+/-1.49 sec, 86.05+/-61.42%/sec and 38.21+/- 28.65%/sec respectively, all of which were significantly different from the other groups, but OR and PR were not different statistically. According to the ROC (Relative Operating Characteristic) table, sensitivity and specificity of OPSE were 72.7 and 80.7% respectively, which were the highest among the parameters. CONCLUSION: Scintigraphy was useful to quantitative dysphagia in patients with brain lesion. Sensitivity and specificity of swallowing efficiency was higher than time and residue parameters. OPSE was considered to be the most useful quantitative parameter for detecting aspiration.

Median Nerve Conduction Velocity of Forearm Segment in Carpal Tunnel Syndrome

OBJECTIVE: To find out the incidence of reduced median conduction velocity of forearm (MNCV-F) in carpal tunnel syndrome (CTS) and to compare clinical and electrophysiologic characteristics of CTS with reduced MNCV-F and to observe the changes of reduced MNCV-F after carpal tunnel release. METHOD: One hundred and fifty nine hands with CTS are divided into two groups; MNCV-F of 50 m/sec and above as group I and that of below 50 m/sec as group II. For the electrophysiologic comparison, median sensorimotor distal latency, peak-to-peak amplitudes and abnormal spontaneous activity of abductor pollicis brevis were observed and for clinical comparison, sensorimotor symptoms, Phalen and Tinel sign were observed. Twenty four hands which had successful carpal tunnel release were examined for the changes of MNCV-F. RESULTS: The hands with reduced MNCV-F were 29 among 159 hands. Sensorimotor distal latency were significantly prolonged and sensorimotor amplitudes also significantly reduced in group II. Sensory change and Phalen signs were more frequently observed in group II. MNCV-F in group I had not changed after carpal tunnel release, but MNCV-F in group II was improved significantly. The changes MNCV-F in group II were much delayed than the improvement of parameters of distal conduction studies. CONCLUSION: The incidence of reduced MNCV-F in CTS was 18.24%. Patients with reduced MNCV-F had more severe CTS both electrophysiologically and clinically. Reduced MNCV-F had improved significantly, but there was significant time gap between the electrophysiologic improvements of distal and proximal portions of nerve. This findings may suggest that retrograde degeneration may play a partial role in reduced forearm motor nerve conduction velocity of the median nerve in CTS.

Restoration of lymphokine-activated killer cell response with indomethacin in tumor bearing mice / 대한면역학회지

No abstract available.