Adult Ileocolic Intussusception Caused by Diffuse Large B Cell Lymphoma / 대한소화기학회지

Intussusception is a medical condition, in which a proximal part of the intestine folds into the distal intestine. Adult intussusceptions are rare and account for approximately 5% of all cases of intussusceptions. The anatomical leading points include tumors, diverticulums, polyps, and strictures in 80-90% of adult intussusceptions, and 65% of colon intussusceptions and 30% of small bowel intussusceptions originate from malignant tumors. Treatments for adult intussusception have not been established, but most cases require surgical treatment. The gastrointestinal tract is the most common extranodal site for non-Hodgkin lymphoma. The symptoms are mostly non-specific, but they rarely lead to complications, such as bleeding, perforation, and intussusception. Furthermore, few cases of primary gastrointestinal lymphomas causing intussusception have been reported. This paper reports a case of small bowel diffuse large B cell lymphoma that caused ileocolic intussusception in a 69-year-old woman with no medical history. She underwent a small bowel resection and received six cycles of adjuvant chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone. Since then, she has been in complete remission.

Neutropenic Enterocolitis due to Mucormycosis in a Patient with Myelodysplastic Syndrome

Neutropenic enterocolitis is a fatal enterocolitis occurring in neutropenic patients with immunocompromised diseases including hematologic malignancies. Gastrointestinal (GI) mucormycosis in hematologic malignancies has been rarely reported. Especially, in myelodysplastic syndrome (MDS), GI mucormycosis has never been reported. We report a case of GI mucormocysis manifesting as neutropenic enterocolitis in a patient with MDS.

A Case of Asymptomatic Multiple Endocrine Neoplasia Type I with Thymic Carcinoid

Multiple endocrine neoplasia type 1 (MEN 1) is an autosomal dominant hereditary disorder caused by germline mutation of the MEN1 gene. It is characterized by tumors of the anterior pituitary gland, parathyroid glands, and endocrine pancreas. Thymic carcinoid tumor is uncommon and associated with a high mortality, but its natural history has not been investigated yet. We report a case of asymptomatic MEN 1 with a thymic carcinoid tumor. A 37-year-old man underwent a routine medical checkup and upper gastrointestinal endoscopy revealed a duodenal neuroendocrine tumor (NET). Further studies showed the coexistence of pancreatic tumor, parathyroid hyperplasia, pituitary adenoma, and thymoma. The patient underwent duodenal endoscopic mucosal resection, distal pancreatectomy, subtotal parathyroidectomy, and thymectomy. The pathological test revealed a duodenal NET, pancreatic NET, parathyroid hyperplasia, and thymic carcinoid tumor. He was treated for MEN 1. We report this asymptomatic case of MEN 1 with a literature review.

Antimicrobial activity of essential oil of Eucalyptus globulus against fish pathogenic bacteria / 한국실험동물학회지

The antibacterial activities of the essential oil of Eucalyptus globulus (EOEG) was determined against 7 fish pathogenic bacteria (Edwardsiella tarda, Streptococcus iniae, S. parauberis, Lactococcus garviae, Vibrio harveyi, V. ichthyoenteri and Photobacterium damselae) obtained from farmed olive flounder. The inhibitory activity was evaluated by three methods: Disc diffusion method, minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). According to the disc diffusion test, as the concentration of EOEG (5-40 µg) rises, the inhibitory zone increases in size. Compared with amoxicillin, tetracycline and chloramphenicol, EOEG showed similar antibacterial activity. The MIC of EOEG ranged from 7.8 to 125 mg/mL and MBC values ranged from 62 to 250 mg/mL. These results show that EOEG has antimicrobial activity against all seven bacteria, but there was no marked difference between each genus. From these results, it is suggested that EOEG can be used as an antimicrobial agent against fish bacterial diseases in the fish industry.

The Natural Course of Endobronchial Inflammatory Polyps as a Complication after Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration / 결핵및호흡기질환

We presented a case of unusual endobronchial inflammatory polyps as a complication following endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in a patient with tuberculous lymphadenitis. EBUS-TBNA of the right hilar lymph node was performed in a 29-year-old, previously healthy man. The patient was confirmed with tuberculous lymphadenitis and received antituberculosis medication over the course of 6 months. Chest computed tomography, after 6 months of antituberculosis therapy following the EBUS-TBNA showed nodular bronchial wall thickening of the right main bronchus. Histological and microbiological examinations revealed inflammatory polyps. After 7 months, the inflammatory polyps regressed almost completely without need for removal.

The Efficacy of ADHD Rating Scale and Continuous Performance Tests in Diagnosis and Treatment of Attention Deficit Hyperactivity Disorder

PURPOSE:Attention deficit hyperactivity disorder(ADHD) is a neurodevelopmental disorder characterized by symptoms of inattention, impulsivity and/or hyperactivity with an onset during childhood. There are no specific diagnostic and evaluated tools. The aim of this study was to determine clinical availability of adjunctive tests for diagnosis and measure of the efficacy of treatment in ADHD patients. METHODS:The study group consisted of 41 patients under 15 years of age who visited Kangnam Sacred Heart Hospital and Kangdong Sacred Heart Hospital between January 2007 and June 2008 for evaluation of ADHD. Diagnosis was made according to the diagnostic and statistical manual for mental disorder-IV(DSM-IV) with history, physical examination, ADHD rating scale, and attention deficit hyperactivity disorder diagnostic system(ADS). After psychostimulant treatment, patients were reevaluated by previous diagnostic tools and their results were analysed by SPSS version 16.0. RESULTS:The mean age was 8.44+/-2.49 years old, male to female ratio 4.13:1(33:8). Forty one ADHD patients were subdivided into predominantly inattentive type 17(41.5%), predominantly hyperactive-impulsive type 3(7.3%) and combined type 21(51.2%). In patients, concordance rates of adjunctive tests with DSM-IV diagnostic criteria were 74.29% in Korean ADHD Rating scale(K-ARS), 59.09% in abbreviated Conners' rating scale(ACRS) and 92.68 % in ADS with DSM-IV diagnostic criteria. There were significant differences in the ADS results between before and after psychostimulant treatment. CONCLUSION:Because the concordance rates and efficacy of ADS were higher than K- ARS and ACRS in ADHD patients, it suggests that ADS is a useful method to ADHD diagnosis and treatment.

Listeria Sepsis and Pneumonia in a Premature Neonate

Listeria monocytogenes (L. monocytogenes) is a foodborne anaerobic gram-positive rod and the third most common pathogen for neonatal meningitis. Although the mortality and morbidity of L. monocytogenes infections are high, thus causing serious problems in Western populations, neonatal listeriosis is relatively rare in Eastern countries, including Korea. Possible routes for intrauterine infection or vertical transmission of L. monocytogenes include infected placentas and the reproductive tract. Intrauterine infections may cause chorioamnionitis, preterm labor, spontaneous abortion, stillbirth, or neonatal infection. A high index of suspicion and early empirical antibiotic treatment are critical to achieve a favorable prognosis for neonatal listeriosis. We managed a case of L. monocytogenes sepsis and pneumonia in a premature neonate born at 26 weeks of gestational age from an asymptomatic mother with culture-proven placental infection. The neonate was successively treated with ampicillin and gentamicin.

Optical Coherence Tomography and Multifocal Electroretinography in a Patient with Choroidal Osteoma

PURPOSE: We present a case of choroidal osteoma and report a pattern of optical coherence tomography and multifocal electroretinography with a literature review. CASE SUMMARY: Using B-scan and CT, we performed OCT and MF-ERG in a patient diagnosed with choroidal osteoma. OCT revealed serous retinal detachment in the macula and a thick, irregular plate-like structure with high reflectivity in the choroidal mass lesion. MF-ERG demonstrated that Trace arrays show suppression of central and peripheral signals, especially in central lesions. Ring averages show reduced amplitudes in all locations, and 3D-topography of the response density shows marked suppression of the central signal and no foveal peak in comparison with the unaffected left eye. CONCLUSIONS: In patients with choroidal osteoma, OCT can reveal thick plate-like high reflectivity with an irregular outer surface, and MF-ERG can predict retinal dysfunction.

A Case of Intraocular Thelasia Callipaeda Infestation

PURPOSE: We report a case of intraocular Thelazia callipaeda infestation in a patient with panuveitis who had a successful recovery after pars plana vitrectomy. METHODS: A 73-year-old female patients complained of a floating sensation and gradually decreasing visual acuity in her right eye. On slit lamp examination, severe intraocular inflammatory reaction was observed. Fundus examination revealed severe vitreous haze with mobile linear structure. Three-port pars plana vitrectomy was performed and then the worm was removed. RESULTS: The worm was confirmed to be Thelazia callipaeda. At postoperative 2 months, the patient's visual acuity was 0.6 and intraocular pressure 14 mmHg. There was no evidence of intraocular inflammatory reaction. CONCLUSIONS: Thelazia callipaeda usually lie in the conjunctival sac or lacrimal apparatus, causing ocular surface disease, but intraocular infestation rarely occurs. If intraocular infestation does occur, early surgical removal should be performed.

Transscleral Diode Laser Photocoagulation for Retinopathy of Prematurity: Five Years' Experience

PURPOSES: We analysed the five-year outcomes and associated complications of transscleral diode laser photocoagulation (TSDLP), used to treat acute proliferative retinopathy of prematurity (ROP), to evaluate the efficacy and safety of this therapy. METHODS: We performed a retrospective analysis of the records of 163 eyes of 82 infants with acute ROP, who were treated with TSDLP by a single surgeon. Follow-up periods ranged from 15 to 278 weeks. RESULTS: The outcome was favorable in 158 eyes (96.9%) and unfavorable in 5 eyes (3.1%) of the 163 eyes that were treated. Vitreous hemorrhage was found to be an indicator of poor prognosis. Of the complications noted, symblepharon was observed in three eyes, hyphema was observed in four eyes, and a complicated cataract was observed in one eye. CONCLUSIONS: The results suggest that TSDLP is a safe and effective in the treatment of ROP. Vitreous hemorrhage should be regarded as a sign of poor prognosis.

Internal Limiting Membrane Peeling with or without Indocyanine Green in Macular Hole Surgery

PURPOSE: In this study, the outcome of internal limiting membrane (ILM) peeling in idiopathic macular hole surgery with or without indocyanine green (ICG) was investigated. METHODS: Thirty eyes of 28 patients with idiopathic macular hole stage 3 or 4 who underwent vitrectomy were included. Follow-up duration in all cases was longer than 6 months. We analyzed the anatomical and functional results of macular hole surgeries using ILM peeling with (15 eyes) and without ICG (15 eyes). RESULTS: There were no significant differences in sex, age, symptom duration, hole size, preoperative corrected visual acuity, or follow-up duration between the two groups. Anatomical success rates were 93.3% (14/15 eyes) in ILM peeling with ICG and 80.0% (12/15 eyes) in ILM peeling without ICG. In the cases of anatomical success, there was a statistically- significant difference between the functional success rates of 50.0% (7/14 eyes) in ILM peeling with ICG and 91.7% (11/12 eyes) in ILM peeling without ICG. CONCLUSIONS: While there was no statistically-significant difference in the anatomic success rate for idiopathic macular hole surgery with and without ICG, our results suggest the ILM peeling using ICG might produce a negative effect on functional success. Further studies are necessary to evaluation the toxicity of ICG in the context of macular hole surgery.