A Case Of Low Grade B Cell Mucosa Associated Lymphoid Tissue Lymphoma Of Jejunum Presenting Recurrent Lower Gastrointestinal Bleeding And Perforation / 대한내과학회지

The accurate diagnosis and localization of gastrointestinal bleeding may use many tests and procedures including serial hematocrits, angiography, scintigraphy, endoscopy, nasogastric aspiration, barium studies and surgery before success is achieved. However, lower gastrointestinal (GI) bleeding is difficult to localize despite above diagnostic procedures. We had experienced a case of mucosa associated lymphoid tissue (MALT) lymphoma of jejunum. In this case, a 61-year-old male was admitted to our hospital with recurrent lower GI bleeding. The cause of recurrent lower GI bleeding was not defined by extensive evaluation including gastrofiberoscopy, colonoscopy, mesenteric angiography, small bowel series. We diagnosed this case as low grade B cell MALT lymphoma after exploratory laparatomy due to bowel perforation.

A Case of Huge Anal Fibroepithelial Polyp with HemorrhoidsMisdiagnosed as Anal Cancer / 대한소화기내시경학회지

The anal fibroepithelial polyps are well-known polypoid conditions histologically consisting of connective tissue response resulting from local irritation, which is closely associated with hemorrhoids. As previously reported, the size of the polyps ranged from 3 to 19 mm, average 9 mm. A 60-year-old women was admitted complaining of anal bleeding and constipation. Colonoscopy revealed a 3.0 2.5 cm sized, subpedunculated polyp on the dendate line. We removed the polyp by per anal local excision due to its hard stalk after failure of colonoscopic removal. The histologic examination was showed mature stratified squamous epithelium with hyalinized vascular changes. We report a case of huge and hard anal fibroepithelial polyp with hemorroids misdignosed as cancer.

Quality of Marital Life in Korean Patients with Fibromyalgia / 대한류마티스학회지

OBJECTIVE: Fibromylagia (FM) is a rheumatic disorder characterized by widespread bodily pain, tenderness, and fatigue. It has a major impact on the quality of life including the quality of marital life. The objectives of this study were to assess the quality of marital life in patients with FM in Korea and to identify the correlation of the quality of marital life with disease severity. MEHTODS: Subjects were the patient group, composed of 50 married patients with FM, and a comparison group composed of 50 healthy married adults with similar demographic characteristics. The quality of marital life was measured using the Korean-Marital Satisfaction Inventory (K-MSI). The K-MSI consists of two valid scales, one global affective scale, and eleven additional scales measuring specific dimensions of relationship distress. The clinical parameters were assessed by Korean Fibromyalgia Impact Questionnaire (KFIQ) and tender point, respectively from 50 patients with FM. RESULTS: Of the 50 subjects, 48 (96%) were women with mean (+/-SD) age of 52.6(+/-8.8) years. The mean (+/-SD) duration of disease was 25.7 (+/-19.8) months. The mean (+/-SD) scores of KFIQ and tender point count were 52.9 (+/-14.9) and 13.1 (+/-1.6), respectively. The T-score of most scales of K-MSI of FM patients were higher than that of healthy controls (p<0.01). The scores of KFIQ were positively correlated with the eight scales of K-MSI and negatively correlated with one scale (Role orientation) of K-MSI. The tender point count was positively correlated with only one of scale (Conflict with in-law) of K-MSI. CONCLUSION: The results suggest that the quality of marital life in Korean patients of FM is lower than healthy subjects. In a simple correlation analysis, KFIQ was a meaningful variable correlated with the quality of marital life.

A Case of Neurogenic Bladder Associated with Systemic Lupus Erythematosus / 대한류마티스학회지

Neurogenic bladder in systemic lupus erythematosus (SLE) has been considered to occur rarely. Myelopathy, cyclophosphamide treatment, vasculitis have been implicated as the causes of the bladder pathology in patients with SLE. In this report, we describe a 46-year- old female with SLE who simultaneously combined with the neurogenic bladder. The diagnosis of neurogenic bladder, attributed to peripheral neuropathy, was made on the basis of cystometrography and clinical symptom. Steroid therapy couldn't improve the clinical manifestation of neurogenic bladder despite the amelioration of the other lupus symptom.

A case of strongyloidiasis with severe malnutrition / 대한내과학회지

Strongyloides stercoralis, which has two different generations: the free living and parasitic generation, is primarily adapted to warm climates, but strongyloidiasis has been reported sporadically in temperate and cold regions. Strongyloidiasis may be asymptomatic in almost 50 percent of the cases, rarely, infestation presents with severe clinical pictures. The reason for this exacerbation of illness is probably a rapid increase in the number of infecting larvas through the development or acceleration of a cycle of autoinfection. A breakdown of the host-parasite equilibrium due to decreased host resistance may occur in malnutrition, debilitating diseases or therapy with immunosuppressive drugs. Corticosteroid treatment may have an important role in the sudden occurrence of severe stongyloidiasis. We experienced a case of strongyloidiasis with severe malnutrition, accompanied with bronchial asthma and diabetes mellitus. This patient has been treated with corticosteroid for several years. So, we report this rare case with the literature review.

A Case of Liver and Spleen Abscesses Secondary to Yersinia Enterocolitica Septicemia in a Chronic Renal Failure Patient on Hemodialysis / 대한신장학회잡지

Yersinia enterocolitica, a gram-negative rod-like organism, has been recognized as an uncommon human pathogen producing a wide spectrum of clinical manifestations. It has been associated with gastroenteritis, acute ileitis, mesenteric lymphadenitis, and erythema nodosum. More recently polyarthritis, chronic arthritis, and Reiter syndrome have been related to previous infection with these organism. Liver and splenic abscesses have been found rarely in Yersinia enterocolitica bactermia, and these have not been reported yet in Korea. We report a case of multiple liver and splenic abscesses secondary to Yersinia enterocolitica septisemia in a chronic renal failure patient on hemodialysis.

A Case of Pulmonary Embolism Induced by Complication of Histoacryl Injection Therapy in Gastric Varix Bleeding / 대한소화기내시경학회지

N-Butyl-2-cyanoacrylate (Histoacryl) has been used successfully to control bleeding from esophagogastric varices since the first report in 1986 by Soehendra. Complications of Histoacryl injection include local sloughing with ulcer formation, rebleeding, sepsis, mediastinitis, esophageal strictures and fever. Systemic embolization, including pulmonary and cerebral embolization, has been reported. We describe here the presentation of an un-usual complication of Histoacryl injection. A 42-year-old woman presented with an attack of massive hematemesis. Endoscopy revealed bleeding evidence of gastric varices. Sclero-therapy was carried out using Histoacryl mixed with Lipiodol (ratio 1 : 1), with complete solidification of the varix. Next morning she complained of dyspnea and tachycardia. The chest x-ray showed multiple metallic densities, consistent with cyanoacrylate mixed with lipoidol, located at central portion. She was diagnosed as having pulmonary embolism by convential precontrast chest CT. She was treated conservatively using oxygen and analge-sics. She recovered soon and was discharged without significant problems.

A Case of Trigeminal Neuropathy Associated with Mixed Connective Tissue Disease / 대한류마티스학회지

The occurrence of a trigeminal neuropathy associated with connective tissue disease is rare. Trigeminal neuropathy in connective tissue disease is predominantly sensory and it is characterized by numbness, hypesthesia, slurred speech, and touch pain. Although the pathogenesis of trigeminal neuropathy associated with connective tissue disease remains obscure, the main pathologic findings are vasculitis and neuritis. A case of trigeminal neuropathy associated with mixed connective tissue disease is described, and the incidence, symptoms, pathophysiology, treatment of the disease is discussed.

Hearing and Visual Loss with Renal Failure Due to Sodium Bromate Poisoning / 대한신장학회잡지

Hair neutralizer in home permanent cold wave kits contains a 2% to 10% potassium or sodium bromate, which is colorless, odorless and tasteless solution. Bromate salts are extremely toxic oxidants. The reported toxic effects of bromates poisoning are vomiting, diarrhea, depression of central nervous system, oliguric acute renal failure, sensorineural hearing loss, peripheral neuropathy and hemolytic anemia. Deafness seems to be almost permanent. In many cases, the recovery of renal function is not complete and some of them are transformed to chronic renal failure and maintained on hemodialysis. Since the serious side effects of deafness and acute renal filure usually occur within 4-16 h after ingestion, prompt removal of the bromate from blood by peritoneal dialysis or hemodialysis, which are proven method of removal, should be performed immediately. Recently, we encountered a 37 year old female hairdresser who was admitted to St. Mary Hospital due to oligura, hearing loss and visual loss after ingestion of sodium bromate. The patient required regular hemodialysis therapy and no recovery of hearing and visual loss was evident up to 8 month follow up.