A Case of Peritoneal Mesothelioma without a History of Asbestos Exposure / 대한소화기학회지

Peritoneal mesothelioma is an unusual disease which diffusely involves the peritoneal surface. The incidence is approximately one per 1,000,000, and one fifth to one third of all mesothelioma are peritoneal in origin. Asbestos exposure is linked to the development of peritoneal mesothelioma as a significant etiology, but further investigation shoud be conducted. Abdominal sonography, abdominal CT and cytologic examination of ascitic fluid are used to confirm the diagnosis, but rarely provides proper diagnosis. Laparoscopy with biopsy is the most common diagnostic method for definite diagnosis of mesothelioma. Cytoreductive surgery and intraperitoneal chemotherapy have been suggested for better survival since the median survival after the initial diagnosis is near to 50 months. This report describes a case of 73-years-old male patient presented with abdominal pain and distension. This patient had not been exposed to asbestos. Abdominal sonography and CT showed massive ascites, multiple omental masses and peritoneal thickening. It was difficult to distinguish peritoneal mesothelioma from carcinomatosis. Laparoscopy and peritoneal biopsy was conducted and immunostaining examination confirmed the diagnosis of peritoneal mesothelioma.

A case of Sweet's syndrome associated with ulcerative colitis / 대한내과학회지

Ulcerative colitis is associated with various cutaneous manifestations such as erythema nodosum, pyoderma gangrenosum. Sweet's syndrome is a rare cutaneous manifestation of ulcerative colitis, and is characterized by tender, red inflammatory plaques or papules, usually affecting the upper limbs, face or neck. We experienced a 68-year-old man with ulcerative colitis who presented general weakness, multiple skin lesions and bloody loose stool. The skin lesions are erythematous, tender plaques on the face, and discrete ulcers with pustules on the extremities and back. The skin biopsy from the lesion on the chin revealed a dense inflammatory cell infiltration composed predominantly of neutrophils in the dermis without leucocytoclastic vasculitis. He was diagnosed as Sweet's syndrome and pyoderma gangrenosum associated with ulcerative colitis. After nine days of oral steroid and steroid enema therapy, the skin lesions and intestinal symptoms were improved markedly.

A Case of Cerebral Salt Wasting Syndrome Associated with Tuberculous Meningitis / 결핵및호흡기질환

Hyponatremia which is due to excessive sodium loss in the urine and decrease in extracellular fluid volume following an acute or chronic central nervous system injury, has been conjunctively described as cerebral salt wasting syndrome (CSWS). This syndrome is often confused with dilutional hyponatremia due to inappropriate secretion of antidiuretic hormone. Accurate diagnosis and management are mandatory for improvement of the course of the disease. This report describes a case of a 31-year-old male patient with CSWS associated with tuberculous meningitis. The patient exhibited hyponatremia, polyuria, excessive natriuresis, volume depletion, and hypotension. He was diagnosed to manifest CSWS and was treated by administration of fluids, salt, and fludrocortisone. After the respective treatments, symptoms of polyuria and hypotension were gradually resolved and hyponatremia was corrected.