A Case of Photodynamic Therapy as a Curative Treatment of Early Esophageal Cancer / 대한소화기내시경학회지

Although the surgical treatment of early esophageal cancer is a well-known curative modality, less invasive endoscopic methods have attracted significant attention recently on account of the fewer postoperative complications, better quality of life and preservation of the integrity of the esophagus. Among the various endoscopic techniques employed, photodynamic therapy (PDT) has been used to allow the selective destruction of malignant tissue through a photochemical effect after the administration of a photosensitizer for curative and palliative treatment purposes. This report describes a case of a 73-year-old man with early esophageal cancer, which had been diagnosed by fluorodeoxyglucose-positron emission tomography (FDG-PET) and endoscopy and a long history of chronic pulmonary diseases such as emphysema and radiation fibrosis. The patient was cured successfully with photodynamic therapy using porfimer sodium as the photosensitizer.

A Case of Aortic Arch Thrombus Associated with Acute Pyelonephritis in a Patient with Thrombocythemia / 대한신장학회잡지

Aortic thrombus is a rare but life threatening disorder. The usual causes of aortic thrombus are primary or secondary thrombocythemia, malignancy, atherosclerosis, trauma, and acute infectious disease. Here, we report a case of aortic arch thrombus associated with acute pyelonephritis in a patient with thrombocythemia. A 78-year-old woman was admitted with acute pyelonephritis. A complete blood cell count showed severe thrombocythemia with platelet count of 1, 340, 000/mm3. Chest CT scan demonstrated floating thrombus in the aortic arch. After antibiotic treatement, platelet count decreased to 770, 000/mm3 and aortic thrombus disappeared without thrombolytic therapy.

Multiple Renal Abscess by Extended-Spectrum beta-Lactamase Producing Escherichia coli / 대한신장학회잡지

Extended-spectrum beta-lactamase (ESBL) producing bacterial infection causes delayed response to antibiotic treatment and consequently results in serious problem, because it can hydrolyze the majority of beta-lactam antibiotics. Here we report a case of multiple renal abscess by ESBL producing Escherichia coli in a patient with diabetes mellitus who had a history of repetitive urinary tract infection. A 49-year old woman was admitted to our hospital because of intermittent fever, left flank pain, and vomiting. She had been diagnosed as acute pyelonephritis and treated with the first and third cephalosporin for 1 month at a clinic. At admission, urinary bacterial culture revealed Escherichia coli resistant to both the first and third cephalosporin such as cefotaxime, ceftriaxone, and ceftazidime. Double disk synergy test confirmed ESBL. Abdominal computed tomography demonstrated multiple renal abscess. After treatment of imipenam for 4 weeks, she discharged with improved condition.

A Case of Recurrent Renal Infarction Due to Fibromuscula Dysplasia / 대한신장학회잡지

Fibromuscular dysplasia (FMD) is an uncommon hyperplastic disorder affecting medium-sized arteries. It can lead to renovascular hypertension, sometimes associated with dissection. But it rarely causes renal infarction. We here report a case of recurrent renal infarction due to FMD. A previously healthy 29- year-old man presented with acute onset of right flank pain. He had been treated for the same symptom 8 years ago. Abdominal CT scan showed renal infarction at upper pole of right kidney. Renal arteriography demonstrated string of bead, consistent with FMD. It showed also old renal infarction at lower pole of right kidney. To our knowledge, recurrent renal infarction due to FMD has not been previously reported.