Thrombotic Thrombocytopenic Purpura as the First Symptom of Systemic Lupus Erythematosus: A Case Report with Review of Literature / 임상소아혈액종양

Thrombotic thrombocytopenic purpura (TTP) can cause serious morbidity and mortality, and differentiating between this disease and systemic lupus erythematosus (SLE) can prove challenging. Although rare, TTP accompanied by SLE is linked to several complications and a higher mortality rate. Herein, we report a case of a 16-year-old boy who presented with systemic symptoms, such as petechiae, and was diagnosed with acquired TTP following a laboratory test. Steroid treatment was initiated and a diagnosis of SLE was reached after the symptoms had improved. Treatment with low-dose prednisone in addition to hydroxychloroquine was continued. The patient did not develop renal failure or neurologic deficit. No specific symptoms were observed after treatment and during the follow-up period. Early treatment of SLE is crucial, but it is difficult to reach an early diagnosis because the symptoms are similar to those of TTP. In the current study, an early diagnosis of TTP led to prompt treatment, thereby avoiding the fatal symptoms that could be caused by SLE.

Impact of non-pharmaceutical interventions on the rate of respiratory viruses other than severe acute respiratory syndrome coronavirus 2 in the coronavirus disease 2019 pandemic

Purpose@#We aimed to evaluate the impact of non-pharmaceutical interventions (NPIs) on the transmission of respiratory viruses other than severe acute respiratory syndrome coronavirus 2 among children during the coronavirus disease 2019 pandemic. @*Methods@#We analyzed the clinical and polymerase chain reaction (PCR) findings using electronic medical records of children (< 18 years) with fever or respiratory symptoms who were hospitalized via the emergency department of Wonkwang University Hospital (Iksan, Korea), from March 2018 through December 2021. The children were divided into before and after groups based on the hospitalization date relative to February 2020, starting point of the implementation of NPIs. PCR was performed using nasopharyngeal swab samples. Between the 2 groups, we compared age, sex, length of hospital stay, and PCR findings. @*Results@#The before and after groups consisted of 3,160 and 989, respectively, showing a 68.7% decrease in the number of children undergoing PCRs after the implantation of NPIs. The after group showed higher median values of the age and length of hospital stay than the before group (Ps < 0.001). A 76.9% decrease was noted in the number of children having PCR positivities (from 1,101 [34.8%] to 254 [25.7%]; P < 0.001). Among detected viruses, an increase in the proportion was noted only in human bocavirus (from 81 [2.6%] to 54 [5.5%]; P < 0.001). In contrast, significant decreases in the proportions were found in adenovirus, enterovirus, influenza A and B, respiratory syncytial viruses A and B, human coronaviruses (229E, NL63, and OC43) and human metapneumovirus. @*Conclusion@#NPIs may be effective in reducing the transmission of respiratory viruses other than severe acute respiratory syndrome coronavirus 2 among children during the pandemic.

Toxic Megacolon as a Complication of Infectious Colitis Caused by Salmonella enteritidis Group D in a Previously Healthy Child

Toxic megacolon is a fatal complication of inflammatory or infectious bowel disease.Prognosis depends on the severity of the disease. In cases of poor prognosis, clinical outcomes range from intestinal resection to death, so early diagnosis and appropriate treatment are very important. However, the prevalence of toxic megacolon in children is very low, and in those without underlying diseases such as inflammatory bowel disease, early diagnosis may be delayed. A previously healthy 12-year-old boy presented to our hospital with lower abdomen pain, fever, and hematochezia. Despite antibiotic therapy, the symptoms worsened. On the third day, abdominal computed tomography revealed severe dilatation of the transverse colon, which indicated toxic megacolon. Stool culture was positive for Salmonella enteritidis group D, and rectal endoscopy showed no signs of inflammatory bowel disease. Ceftriaxone and intravenous methylprednisolone were administered, and the patient's condition improved without any complications. We report a case of toxic megacolon as a complication of infectious colitis caused by S. enteritidis group D, which was diagnosed using early imaging and successfully treated without surgical intervention.

Toxic Megacolon as a Complication of Infectious Colitis Caused by Salmonella enteritidis Group D in a Previously Healthy Child

Toxic megacolon is a fatal complication of inflammatory or infectious bowel disease.Prognosis depends on the severity of the disease. In cases of poor prognosis, clinical outcomes range from intestinal resection to death, so early diagnosis and appropriate treatment are very important. However, the prevalence of toxic megacolon in children is very low, and in those without underlying diseases such as inflammatory bowel disease, early diagnosis may be delayed. A previously healthy 12-year-old boy presented to our hospital with lower abdomen pain, fever, and hematochezia. Despite antibiotic therapy, the symptoms worsened. On the third day, abdominal computed tomography revealed severe dilatation of the transverse colon, which indicated toxic megacolon. Stool culture was positive for Salmonella enteritidis group D, and rectal endoscopy showed no signs of inflammatory bowel disease. Ceftriaxone and intravenous methylprednisolone were administered, and the patient's condition improved without any complications. We report a case of toxic megacolon as a complication of infectious colitis caused by S. enteritidis group D, which was diagnosed using early imaging and successfully treated without surgical intervention.

Paraspinal Ancient Schwannoma of the Dorsal Ramus Nerve: A Case Report / 대한척추외과학회지

STUDY DESIGN: Case report. OBJECTIVES: We report a case of paraspinal ancient schwannoma located at the upper thoracic level that mimicked an atypical lipoma or complicated epidermoid cyst. SUMMARY OF LITERATURE REVIEW: Few case reports of paraspinal schwannoma have been reported and the incidence of ancient schwannoma in the paraspinal muscle layer is very rare. MATERIALS AND METHODS: A 39-year-old man complained of a growing palpable back mass for 5 years. He experienced aggravated chronic discomfort around the mass while lying down. Both T1- and T2- weighted magnetic resonance imaging (MRI) showed a well-capsuled and heterogeneous high-signal mass in the muscle layer at the level from the T1 to T4 vertebral bodies on the right side of the midline. The tumor was completely removed by en bloc resection. RESULTS: The pathologic examination revealed S-100 protein expression with degenerative changes. The lesion was diagnosed as an ancient schwannoma. CONCLUSIONS: Schwannoma is one among the multiple possible causes of benign back masses. If a mass reveals a well-encapsulated heterogeneous mass on contrast MRI, a schwannoma should be suspected.

A Case of Infantile Fungal Urinary Tract Infection

Urinary tract infection is common in the pediatric population. The most common causative agents are bacteria, among which Escherichia coli is the most frequent uropathogen. Although fungal urinary tract infection is rare in the healthy pediatric population, it is relatively common among hospitalized patients. Fungus may be isolated from the urine of immunocompromised patients or that of patients with indwelling catheters. The most common cause of funguria is Candida albicans. Although more than 50% of Candida isolates belong to non-albicans Candida , the prevalence of non-albicans candiduria is increasing. Herein, we report a case of community-acquired candiduria in a 4-month-old immunocompetent male infant who had bilateral vesicoureteral reflux and was administered antibiotic prophylaxis. He was diagnosed with urinary tract infection caused by Candida lusitaniae and was managed with fluconazole.

Paraspinal Ancient Schwannoma of the Dorsal Ramus Nerve: A Case Report

OBJECTIVES@#We report a case of paraspinal ancient schwannoma located at the upper thoracic level that mimicked an atypical lipoma or complicated epidermoid cyst.SUMMARY OF LITERATURE REVIEW: Few case reports of paraspinal schwannoma have been reported and the incidence of ancient schwannoma in the paraspinal muscle layer is very rare.@*MATERIALS AND METHODS@#A 39-year-old man complained of a growing palpable back mass for 5 years. He experienced aggravated chronic discomfort around the mass while lying down. Both T1- and T2- weighted magnetic resonance imaging (MRI) showed a well-capsuled and heterogeneous high-signal mass in the muscle layer at the level from the T1 to T4 vertebral bodies on the right side of the midline. The tumor was completely removed by en bloc resection.@*RESULTS@#The pathologic examination revealed S-100 protein expression with degenerative changes. The lesion was diagnosed as an ancient schwannoma.@*CONCLUSIONS@#Schwannoma is one among the multiple possible causes of benign back masses. If a mass reveals a well-encapsulated heterogeneous mass on contrast MRI, a schwannoma should be suspected.

Prognostic Significance of Aquaporin 5 Expression in Non-small Cell Lung Cancer

BACKGROUND: Aquaporins are water channel proteins that play a major role in the movement of water in various human tissues. Recently, it has been found that aquaporins have influence in the carcinogenesis of human malignancies. We analyzed the prognostic impact of aquaporin 5 (AQP5) in non-small lung cancer (NSCLC). METHODS: Seventy-six cases of NSCLC were studied, including 44 cases of adenocarcinoma (ADC) and 32 cases of squamous cell carcinoma (SQCC). Tissue microarray was constructed and immunohistochemical staining for AQP5 was performed. RESULTS: AQP5 was positive in 59.2% of the total enrolled NSCLCs (63.7% in ADC and 53.1% in SQCC). The difference in expression of AQP5 according to the histologic grade of the tumor was significant (p<.047), but not in a serial order. When ADC and SQCC were separately evaluated, no significant difference was observed according to the histologic grade of the tumor (p=.076 in ADC and p=.631 in SQCC). No difference was observed between AQP5 expression and other demographic data and tumor characteristics. Disease-free survival (DFS) was higher in AQP5 negative cases than positive cases in ADC (p=.047), but no significance was found in SQCC (p=.068). We were unable to find a significance between AQP5 overexpression and overall survival in either ADC (p=.210) or SQCC (p=.533). CONCLUSIONS: AQP5 expression is associated with DFS in ADC of the lung and tumor grade of NSCLC. The present study suggests that AQP5 can be a prognostic factor of NSCLC.

Diffuse Pulmonary Ossification Developing in Patients with End-stage Renal Disease / 대한내과학회지

Diffuse pulmonary ossification (DPO) is a rare condition characterized by chronic metaplastic ossification of the lung parenchyma. DPO is associated with various underlying pulmonary, cardiac, and systemic diseases. However, to our knowledge, DPO has rarely been described in patients with end-stage renal disease undergoing hemodialysis. We describe two cases of DPO diagnosed in long-term hemodialysis patients. Awareness of this rare disorder is required for a better differential diagnosis of cases presenting with bilateral diffuse micronodular lesions, including calcific opacities.

Gastric Mixed Adenoneuroendocrine Carcinoma with Squamous Differentiation: A Case Report

No abstract available.

A Case Report of Suicide by Cutting the Tongue with a Pair of Scissors / 대한법의학회지

Common methods of suicide are hanging, toxic substance ingestion, descent from height, and drowning. However, suicide by cutting the tongue is very rare and there are almost no reported cases in the literature. A 76-year-old man who had terminal gastric cancer with multiple liver metastases was found dead in his home. Upon autopsy, it was noted that his tongue was cut by a pair of scissors four times and copious blood was identified in the stomach and intestine. The total loss of blood volume was approximately 750 mL. He had also cut his finger-tip and stabbed his abdomen with a pair of scissors. We concluded that lingual artery injury by scissors was the cause of death.