A Case of Gastritis Cystica Profunda Presenting with a Submucosal Cystic Tumor / 대한소화기내시경학회지

Gastritis cystica profunda (GCP) is a lesion characterized by elongation of the gastric foveolae with hyperplasia and cystic dilatation of the gastric glands that extends into the submucosal layer. In most cases, gastritis cystica profunda develops in patients who have undergone a gastroenterostomy, with or without gastric resection. GCP may present not only as a submucosal tumor or as solitary or diffuse polyps, but GCP is also rarely seen as a giant gastric mucosal fold. A patient arrived at our hospital with dyspepsia. Gastroduodenoscopy (EGD) showed the presence of a submucosal tumor measuring 3 cm in the widest diameter in the body of the stomach. A CT scan demonstrated the cystic nature of the lesion and endoscopic ultrasound (EUS) depicted a homogeneous hypoechoic, unilocular cystic mass without any internal solid component. EGD, CT and EUS findings suggested that the lesion was more likely to be benign than malignant. The lesion was treated with an endoscopic mucosal resection (EMR), and the lesion was finally diagnosed as gastritis cystica profunda. A follow-up EGD demonstrated that all mucosal surfaces were well healed four weeks after the EMR.

Localized Pulmonary Edema in Patient with Severe Mitral Regurgitation / 결핵및호흡기질환

An 82-year-old female non-smoker with a history of hypertension presented with increasing dyspnea, cough and some purulent sputum without fever. Upon admission, the patient was in a distressed condition. Auscultation revealed diminished breath sounds with no rales over the right lung. An examination of the heart revealed a regular rhythm and a systolic murmur radiating from the apex of the heart. There was no pitting edema in the lower extremities. The blood tests showed mild leukocytosis and an increased C-reactive protein level. The O2 saturation was 98 % whilst breathing room air. The electrocardiogram demonstrated sinus tachycardia. The chest radiograph showed a moderate cardiomegaly, right lobe infiltrates, and blunting of the both costophrenic sulcus suggesting a small pleural effusion. Three days after admission, the symptoms became slightly aggravated despite being treated with empirical antibiotics for presumed community-acquired pneumonia. Transthoracic color Doppler echocardiography indicated an ejection fraction of 48 %, mild left ventricular enlargement, and moderate left atrial enlargement resulting in severe mitral regurgitation. The clinical symptoms and right pulmonary edema resolved quickly with intravenous furosemide treatment.

Necrotizing Pneumonia Complicated by Streptococcus Pyogenes Bacteremia in Patient with COPD / 결핵

No abstract available.

Unresolving Pneumonia / 결핵및호흡기질환

A 47-year-old-man was admitted to the emergency department with dyspnea, right pleuritic pain, and high fevers for 3 days. He had a nonproductive cough that exacerbated the chest pain. A clinical examination revealed distressed and slightly tachypneic patient, with blood pressure of 110/90 mmHg, temperature of 39degrees C, pulse of 90 beats/min, respiratory rate of 24 breaths/min. A chest examination showed significantly diminished breath sounds in the right lung with dullness to percussion. Laboratory investigation demonstrated leukocytosis and a raised C-reactive protein. The results of arterial blood gas analysis revealed moderate hypoxemia. A radiograph and a CT scan of the chest showed extensive consolidation with multifocal low densities, and pleural effusion in the right lung. A diagnostic thoracentesis revealed straw-colored fluid, which was found to be a neutrophil-predominant exudate. At 7 days after admission, the clinical symptoms had not improved and the temperature was still 39degrees C despite the aggressive therapy of community- acquired pneumonia. After comprehensive history taking, we realized then that he accidentally aspirated kerosene while siphoning from fuel tank to put into the boiler 3 days ago. Bronchoscopy with bronchial washings could be successful in establishing the diagnosis of hydrocarbon pneumonitis by demonstration of a high lipid-laden macrophage index. Thereafter, the symptoms and radiographic opacities gradually improved, and he was discharged several days later.

A Measles Outbreak Among Adults in Daejeon City, 2001

BACKGROUND: Measles is a highly infectious disease throughout the world and has not yet been eradicated with aggressive vaccination in Korea since 1960's. Recently, measles outbreaks have occurred periodically every 2 to 4 years. Unlike measles in children, few clinical studies on the measles of adult in our domestic area were carried out. In this study, we analyzed epidemiologic and clinical features of adult measles patients. METHODS: From January to June in 2001, 23 adult measles patients were admitted in Sun general hospital in Daejeon. Epidemiologic findings, clinical course, and laboratory findings were reviewed retrospectively. RESULTS: Measles was predominant in male patients (M : F=2.3 : 1). Many of the patients were late teenagers and early twenties. Major symptoms were fever (100%), cough (100%), rash (100%), diarrhea (69.6%), vomiting (60.9%), headache (60.9%), rhinorrhea (30.4%), and sore throat (30.4%). Koplik spot was observed in 11 (47.8%) patients. Rash appeared 1-6 days after the onset of fever. Fever lasted for 5-9 days and cough lasted for 10-14 days. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were elevated in 12 (52.2%) and 9 (39.1%) patients, respectively. Only 14 (60.9%) patients were seropositive for measles specific IgG antibody, but all the patients were seropositive for measles specific IgM antibody. No fatal complication was observed. CONCLUSION: Gastrointestinal symptom and hepatic dysfunction were the clinical characteristics of adult measles outbreak in Daejeon, 2001. Different from previous studies, all patients were seropositive for measles specific IgM antibody.

A Measles Outbreak Among Adults in Daejeon City, 2001

BACKGROUND: Measles is a highly infectious disease throughout the world and has not yet been eradicated with aggressive vaccination in Korea since 1960's. Recently, measles outbreaks have occurred periodically every 2 to 4 years. Unlike measles in children, few clinical studies on the measles of adult in our domestic area were carried out. In this study, we analyzed epidemiologic and clinical features of adult measles patients. METHODS: From January to June in 2001, 23 adult measles patients were admitted in Sun general hospital in Daejeon. Epidemiologic findings, clinical course, and laboratory findings were reviewed retrospectively. RESULTS: Measles was predominant in male patients (M : F=2.3 : 1). Many of the patients were late teenagers and early twenties. Major symptoms were fever (100%), cough (100%), rash (100%), diarrhea (69.6%), vomiting (60.9%), headache (60.9%), rhinorrhea (30.4%), and sore throat (30.4%). Koplik spot was observed in 11 (47.8%) patients. Rash appeared 1-6 days after the onset of fever. Fever lasted for 5-9 days and cough lasted for 10-14 days. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were elevated in 12 (52.2%) and 9 (39.1%) patients, respectively. Only 14 (60.9%) patients were seropositive for measles specific IgG antibody, but all the patients were seropositive for measles specific IgM antibody. No fatal complication was observed. CONCLUSION: Gastrointestinal symptom and hepatic dysfunction were the clinical characteristics of adult measles outbreak in Daejeon, 2001. Different from previous studies, all patients were seropositive for measles specific IgM antibody.