A Case of Delayed Hemolytic Transfusion Reaction Due to Anti-E(rh") / 대한내과학회지

Delayed hemolytic transfusion reaction occurs when the transfused red cells possess an antigen to which the patient has been previously sensitized. Red cells are destructed by an antibody not detected by compatibility testiing some time after the transfusion. Anti-E(rh") is the Rh antibody that found second most commonly after anti-D in Korea, but very seldom causes hemolytic disease. Recently we experienced a case of delayed hemolytic transfusion reaction due to anti-E(rh") in a 37-year-old woman. Three days after the transfusion, she showed a fall in hematocrit and elevation of indirect bilirubin and LDH accompanied by a positive indirect antiglobulin test. Anti-E(rh") was identified in the patient's serum by antibody screening and identification test.

A Case of Premature Coronary Atherosclerosis Associated with Systemic Lupus Erythematosus

Cardiac involvement in systemic lupus erythematosus(SLE) is common and has been reported in more than 50% of the patients at the same stage during their illness. SLE can affect the heart in a number of ways;myocarditis, pericarditis, aortic insufficiency, hypertensive heart disease, and coronary arteritis. In recent years, with prolonged survival and improvement in diagnostic modalities, the cardiovascular manifestations of SLE have become more apparent. Coronary artery disease has a number of possible pathogenic mechanisms;atherosclerosis, coronary arteritis, spasm, and hypercoagulability. For management purposes, differentiation between arteritis and artheroslerosis is important. Atherosclerosis in the coronary as well as other vessels appears to be accelerated by SLE. Cardiovascular care to the SLE patients should be emphasized, because corticosteroid treatment and auto-immune mechanisms of SLE are able to promote the atherosclerosis of coronary arteries. We report 36-year-old otherwise healthy female with SLE who presented with severe ischemic heart disease requiring coronary by-pass surgery.

Three Cases of Primary Adenocarcinoma of the Buodenal Dulb / 대한소화기내시경학회지

Duodenal tumor is relatively rare disease, accounting for about 0.3% of all carcinomas of the gastrointestinal tract. Although radiological and endoscopic examinations have become popular, we are not so familiar with the duodenal tumors as those of the other gastrointestinal tumors. The absence of precise symptoms and the rarity of primary malignant neoplasms in this localization are frequently the reason for the late diagnosis. And so, often the true nature and localization of the tumor are only determined during surgery or autopsy. But, recently, duodenal bulb is examined with ease and pathologic diagnosis is possible following the diffusion of panendoscopy. We have experienced three cases of primary duodenal bulb carcinoma, which diagnosed by biopsies with gastrofibroscopic endoscopy. So we report the cases with a brief review of literature.

A Case of Bleeding from Jejunal Leiomyosarcoma Diagnosed with Small Bowel Enteroscopy / 대한소화기내시경학회지

In the evaluation of the source of occult bleeding, it is mandatory that the small bowel be investigated. But, the small bowel is the area where endoscopic approach is most difficult. The endoscopic evaluation of the small intestine has rapidly evolved over the last 10 years and now includes many of the diagnostic and therapeutic capabilities of standard endoscopic procedures. Various techniques have been developed, including fiberoptic sonde enteroscopy, retrograde ileoscopy, intraoperative enteroscopy, "push" enteroscopy using a pediatric colonoscope, and video enterocopy. Therefore, the small bowel enteroscope has shown great promise in the evaluation of obscure or persistent gastrointestinal bleeding. We have experienced a case of bleeding from jejunal leiomyosarcoma, which diagnosed with small bowel enteroscopy. So we report the case with a brief review of literature.