A Case of Submucosal Tumor-like Gastric Mucinous Adenocarcinoma Showing Mucin Waterfall / 대한소화기내시경학회지

Muinous gastric carcinoma (MGC) is a rare histological type that accounts for approximately 3~7% of all gastric carcinomas. The results of clinicopathological studies suggest that the overall survival rate for patients with MGC is worse than that for patients with non-mucinous tumors as MGC is more frequently diagnosed in the advanced stage. In this report, we preoperatively predicted the type of a tumor from its endoscopic finding. An endoscopic ultrasonographic examination showed a submucosal tumor like mass showing mucin waterfall on the gastric cardia. A total gastrectomy with splenectomy was performed. The pathology of the tumor identified the lesion as a mucinous adenocarcinoma.

A case of complete atrioventricular block in neonatal lupus erythematosus / 대한내과학회지

Neonatal Lupus Erythematosus (NLE) is a disease of the newborn defined by presence of maternal autoantibodies and characteristic clinical features (congenital complete atrioventricular block, skin lesion, etc.). Although the autoantibodies often are not associated with clinical disease in the mother, NLE is likely the result of fetal or neonatal tissue damage caused by maternally transmitted IgG autoantibodies. The majority of morbidity and mortality of NLE results from congenital complete atrioventricular block. Most of the neonates with NLE have maternally transmitted anti-SSA/Ro antibodies. Anti-SSB/La antibodies are found in 40 to 50 percent of patients. Anti-SSA/Ro antibodies are the most important autoantibodies in the pathophysiology of NLE. Noncardiac manifestations of neonatal lupus are transient, resolving at about 6 months of life, coinciding with the disappearance of maternal autoantibodies from neonatal circulation. Congenital complete atrioventricular block is irreversible, and permanent pacemaker insertion is needed. We report a case of NLE with congenital complete atrioventricular block with literature reviews.

The Comparison of Serum Lipid Levels and Risk Factors according to the Status of Coronary Atherosclerosis in Koreans

BACKGROUND AND OBJECTIVES: The aims of this study were to compare the lipid distributions and risk factors in an angiographically normal coronary artery group to those of microvascular and coronary artery diseased groups of Koreans, and to find the effects of the variable risk factors on the serum lipid levels according to the coronary atherosclerosis status. SUBJECTS AND METHODS: A total of 1,198 patients (563 males and 635 females), having undergone a coronary angiography (CAG) using Judkins method, were included. According to their coronary angiographic findings, they were divided into normal CAG (n=568), microvascular disease (n=230) and coronary atherosclerosis (n=400) groups. RESULTS: The mean value of the total cholesterol in the patients with normal coronary artery was 175 mg/dl, which progressively increased to 182 mg/dl and 198 mg/dl in the patients with microvascular disease and coronary atherosclerosis, respectively. The frequencies of the risk factors for coronary atherosclerosis also progressively increased in the patients with microvascular disease and coronary atherosclerosis. The mean values of the serum total cholesterol, LDL-cholesterol and lipoprotein(a), progressively increased from the patients with normal angiographic findings to those with microvascular disease and coronary atherosclerosis, and the results were statistically significant. The results for the patients with microvascular disease were in between those of the patients with normal angiographic findings and those with coronary atherosclerosis. CONCLUSION: The correlation between coronary atherosclerosis and the serum cholesterol levels has, until now, been studied epidemiologically, and this is the first study to angiographically elucidate the positive relationship between coronary artery disease and the serum cholesterol levels. Our data showed lower ranges of lipid distributions compared to those of the ATP III guideline.

A Case of Moyamoya Disease with Total Occlusion of Left Main Coronary Artery

Moyamoya disease is an occlusive intracranial arteriopathy with an abnormal cerebral vascular collateral network at the base of brain. Despite strict diagnostic guidelines for moyamoya disease, the etiology and pathogenesis remains unknown. There are several reports that moyamoya disease should be regarded as a systemic vascular disorder. However, Moyamoya and coronary artery disease may have common etiologic factors. We decribe here a 35-year-old female with moyamoya disease that was diagnosed as severe coronary artery disease. Coronary angiography showed a left main ostial total obstruction with TIMI grade III collateral blood supply from the normal right coronary artery. We report the first clinical case of moyamoya disease with left main ostial total obstruction in a Korean patient and recommend that an evaluation of the extracranial (especially coronary artery) vascular system should be considered if there is some evidence of coronary artery disease.