ABSTRACT
A 29-year-old man was admitted because of melena for 5 days. Two years ago, he underwent allogenic bone marrow transplantation for chronic myeloid leukemia and received immunosuppressive agents. Esophagogastroduodenoscopy showed a picture - multiple scattered deep ulcers and friable pseudomembranes - of highly suggestive of a herpes simplex esophagitis and biopsy revealed multinucleated giant cells and pathognomonic intranuclear inclusion bodies. Esophageal lesions and melena improved after acyclovir therapy.
Subject(s)
Adult , Humans , Acyclovir , Biopsy , Bone Marrow Transplantation , Endoscopy, Digestive System , Esophagitis , Esophagus , Giant Cells , Herpes Simplex , Immunosuppressive Agents , Intranuclear Inclusion Bodies , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Melena , UlcerABSTRACT
Diffuse esophageal spasm (DES) is a motility disorder of the esophagus characterized by symptoms of retrosternal chest pain and intermittent dysphagia. The diagnosis of DES has relied on criteria obtained from a standard esophageal manometry (more than one simultaneous contraction in a series of 10 wet swallows with the rest being peristaltic). Because symptoms and/or typical manometric findings are not always documented during the standard manometry, 24 hour manometry may be more useful in such cases. We recently assessed a 29-year-old male patient who complained of chest pain and dysphagia. He showed nonspecific findings on the laboratory based manometry, but DES was diagnosed by his typical manometric findings on the 24 hour manometry. Therefore, a 24 hour manometry should always be performed when the patient's history suggests the presence of DES and the laboratory based manometry failed to detect the symptomatic contractions of DES. Following we report this case with a review of the literature.
Subject(s)
Adult , Humans , Male , Chest Pain , Deglutition Disorders , Diagnosis , Esophageal Spasm, Diffuse , Esophagus , Manometry , SwallowsABSTRACT
BACKGROUND/AIMS: Generally, it is recommended for patients with gastroesophageal reflux disease to sleep with the head of the bed elevated; however, many patients in Korea do not have heartburn symptoms during the night. METHODS: We investigated the pattern of acid reflux in patients who were diagnosed as having definite pathological acid reflux on 24-hour pH monitoring. RESULTS: One hundred patients were categorized into 3 groups; upright refluxer (68%), supine refluxer (2%), or combined refluxer (30%). Acid reflux was rare in supine positions but instead, usually occurred in upright positions. Acid reflux was found to occur most commonly after meals. The reflux symptoms occurred during pH monitoring with the average frequency of 5.5 times (total of 254 times) in 46 patients. The acid related symptoms were more common in the upright period and postprandially than the supine period. The presence of an esophagitis, an esophageal motility disorder, or the LES pressure did not make a significant difference between upright refluxer and supine refluxer. CONCLUSIONS: Gastroesophageal reflux was found to be rare in supine positions but usually occurred in upright positions. Gastroesophageal reflux occurred most commonly after meals, and was frequently associated with reflux symptoms.
Subject(s)
Humans , Esophageal Motility Disorders , Esophagitis , Gastroesophageal Reflux , Head , Heartburn , Hydrogen-Ion Concentration , Korea , Meals , Supine PositionABSTRACT
After bone marrow transplantation (BMT), recipients can be complicated by infectious or non-infectious chest lesions such as mycobacterial infections or post- transplant lymphoproliferative disorders (PTLDs). BMT recipients usually face a lot of risks of mycobacterial infection because they have severely impaired cell- mediated immunity as a result of their underlying disease, chemotherapy, radiotherapy, acute or chronic graft-versus-host diesase (GVHD) and their treatment. We report a case of mediastinal tuberculous abscess and lymphadenitis after BMT, which mimicks PTLDs. 20 months before admission, BMT was performed on a 41 year-old woman who was diagnosed as chronic myelocytic leukemia. She showed acute and chronic GVHD with several infections of bacteria or viruses after BMT. In endemic area of tuberculosis such as Korea, PTLDs should be differentiated from pulmonary tuberculosis and tuberculous lymphadenitis.
Subject(s)
Adult , Female , Humans , Abscess , Bacteria , Bone Marrow Transplantation , Bone Marrow , Drug Therapy , Korea , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Lymphadenitis , Lymphoproliferative Disorders , Radiotherapy , Thorax , Tuberculosis , Tuberculosis, Lymph Node , Tuberculosis, PulmonaryABSTRACT
BACKGROUND: Endemic malaria has become increasingly rare since the late 1970s, but since the reemergence of indigenous vivax malaria in 1993, the number of cases of malaria have recently increased. We analyzed the cases of malaria who were treated in Kangnam St. Mary's Hospital with regards to epidemiology, clinical manifestations, and treatment outcome, and made a comparison between indigenous and imported cases. METHODS: We retrospectively analyzed data of 40 confirmed cases of malaria treated in the same hospital. RESULTS: Twenty-one cases were indigenous and 19 were imported malaria. Peripheral blood smear revealed Plasmodium vivax in all indigenous malaria, whereas in imported cases 13 were P. falciparum and 6 were P. vivax. Yeonchon-gun(7 cases) was the most prevalent area in the indigenous cases; Africa and Southeast Asia(7 cases, respectively) were the most prevalent areas in the imported cases. Anemia(hemoglobin <10g/dL) was found more frequently in the imported cases, but the difference was not statistically significant. One patient, who was infected in South America showed initially resistant to primaquine, but was cured after extended treatment with increased dosage of primaquine. CONCLUSION: As cases of indigenous malaria in Korea are increasing, early diagnosis, treament, and prevention of malaria are important. To prevent imported malaria, anyone who travels to endemic areas should receive proper education and chemoprophylaxis, considering the pattern of drug resistance.
Subject(s)
Humans , Africa , Chemoprevention , Drug Resistance , Early Diagnosis , Education , Epidemiology , Korea , Malaria , Malaria, Vivax , Plasmodium vivax , Primaquine , Retrospective Studies , South America , Treatment OutcomeABSTRACT
Hemangiopericytoma is a rare vascular tumor arising from pericytes. The tumor usually develops in the skin or subcutaneous tissue, particularly in the extremities.4 pulmonary origin of hemangiopericytoma is known to be quite rare. It has the potential to become a highly malignant lesion, so wide excision is the treatment of choice. We present a case of primary malignant hemangiopericytoma of the lung and discuss the clinical symptoms, diagnosis, therapy and prognosis within the context of a brief review.