Insertion of Self Expandable Metal Stent for Malignant Stomal Obstruction in a Patient with Advanced Colon Cancer

Self expandable metal stent can be used both as palliative treatment for malignant colorectal obstruction and as a bridge to surgery in patients with potentially resectable colorectal cancer. Here, we report a case of successful relief of malignant stomal obstruction using a metal stent. A 56-year-old man underwent loop ileostomy and was given palliative chemotherapy for ascending colon cancer with peritoneal carcinomatosis. Eight months after the surgery, he complained of abdominal pain and decreased fecal output. Computed tomography and endoscopy revealed malignant stomal obstruction. Due to his poor clinical condition, we inserted the stent at the stomal orifice, instead of additional surgery, and his obstructive symptoms were successfully relieved. Stent insertion is thought to be a good alternative treatment for malignant stomal obstruction, instead of surgery.

A Case of Nonspecific Interstitial Pneumonia with Clinical Course of Rapid Aggravation / 결핵

Nonspecific interstitial pneumonia (NSIP) was first described as a new category of idiopathic interstitial pneumonia in 1994. This is a disease with a more insidious onset and has a chronic course. The histological findings are unusual for other idiopathic interstitial pneumonia cases (usual interstitial pneumonia, diffuse interstitial pneumonia, and acute interstitial pneumonia). In contrast to NSIP, acute interstitial pneumonia (AIP) has an acute onset and a fulminant course with the rapid development of respiratory failure. A pathological examination demonstrated characteristic diffuse interstitial fibrosis, hyaline membranes, thrombi, and architectural derangement. Here we report a 48-year-old woman who was diagnosed pathologically NSIP, but with a rapid progressive course similar to AIP.

Hypokalemia due to barium carbonate intoxication / 대한내과학회지

Barium carbonate is commonly used rodenticidally and industrially, but intoxication has been uncommonly reported. Muscle weakness and hypokalemia are the characteristic features of barium carbonate intoxication. Barium-induced hypokalemia is due to a rapid and large transfer of potassium from the extracellular space into the intracellular space resulting from blocking potassium channels by barium ions. We report 35 cases of barium carbonate intoxication which developed after accidental ingestion of barium poisoned noodle. All patients developed severe hypokalemic paralysis and some degree of vomiting and diarrhea. We managed these patients with aggressive potassium supplementation and all patients were discharged without any sequelae.

Congenital Giant Left Circumflex Artery-to-Left Ventricle Fistula Detected Using Two-Dimensional and Doppler Echocardiography

Coronary arteriovenous fistula is a rare congenital coronary artery anomaly in adults. Most such fistula drain into a right heart chamber or into the pulmonary artery. Congenital left coronary artery-left ventricle fistula is even more uncommon. Aortography and selective coronary angiography are still the diagnostic mode of choice. However, recent studies have demonstrated that two-dimensional echocardiography with or without Doppler color flow imaging is a useful noninvasive tool in the diagnosis of coronary artery fistula. A 29 year-old female who had an exertional dyspnea, chest pain, and continuous diastolic murmur was referred to our hospital for further evaluation. The transthoracic two-dimensional and color Doppler echocardiography revealed a dilated left coronary artery which was drained into left ventricle. The coronary angiography showed that the left circumflex artery was very dilated and tortuous, and contrast medium passed from the left circumflex artery into the left ventricular cavity via a fistula. However, the right coronary artery and the left anterior descending artery were normal. We reported a case of an echocardiographically documented fistula between the left circumflex coronary artery and the left ventricle in young woman.

A Case of Isolated Protein S Deficiency, complicated by Acute Pulmonary Thromboembolism after Coronary Angiography

No abstract available.

A Case of Sparganosis in Renal Allograft Recipient / 대한이식학회지

Human sparganosis is a rare parasitic disease infected by plerocercoid larva (sparganum) of Spirometra species. It was usually diagnosed accidentally. In this article, we report a 44-year-old woman reanl allofraft recipient on cyclosporine and prednisolone as the immunosuppressive agents. She presented an enlarging subcutaneous nodule in the left thigh for 20 days, which was excised in the belief that it was a seroma. Characteristic sparganum lava accompanied by granulomatous inflammation and cyst formation in the subcutaneous tissue were discovered under microscopic examination of the excised tissue. However, the infectious source was not clear.

A Case with Disseminated Macrophage-related Histiocytic Sarcoma Diagnosed by Positive Histiocytic Markers / 대한혈액학회지

Malignant histiocytosis (MH) is characterized by an invasive, progressive proliferation of neoplastic histiocytes associated with jaundice, lymphadenopathy, refractory anemia, leukopenia, and often hepatic and splenic enlargement. As lymphoblastic leukemia and lymphoma are regarded as neoplasms of lymphoid cells, MH is thought to represent a malignant transformation of the macrophage and dendritic cells. A classification of malignant histiocytic disorders was oriented by cell lineage in the Histiocyte Society's 1987 version. So dendritic cell-related histiocytic sarcoma (localized or disseminated) and macrophage-related histiocytic sarcoma (localized or disseminated) are the recommended nosology. To establish the correct diagnosis, the major challenge seems to distinguish lymphoid from histiocytic cells. M-CSF receptor, lysozyme, Ki-M8, and S-100 protein, etc are useful markers for histiocytes and T-cell and B-cell lineage markers, such as CD3, CD20, and CD79, etc, for lymphocytes. We have experienced a patient with disseminated histiocytic sarcoma diagnosed by positive istiocytic markers, such as lysozyme, S-100 protein, and CD68.

Candidal REnal Papillary Necrosis Treated with Bilateral Nepherectomy: Report of a Case / 대한신장학회잡지

Renal papillary necrosis(RPN) is a 4bointerstitial nephropathy accompanied by compromised medullary blood flow that ultimately results in a focal or diffuse ischemic necrosis of segments of the renal medulla. Renal papillary necrosis is infrequently reported as complication of fungal infections. Underlying condi- tions such as prematurity, immunosuppressive therapy, neoplastic disease, previous antibiotic therapy, diabetes mellitus, extensive burn and indwelling vascular catheters were found in candidal RPN. Candidal renal papillary necrosis is a extremely rare and fatal disease. Only 20 cases were reported over the past. There were only three survivors which were diagnosed were treated with antifugal agents early in the clinical course. As far as we know, this case is the first case of candidal RPN treated with bilateral nephrectomy. We report a case of candidal renal papillary necrosis in a 66-year-old diabetic woman treated with bilateral nephrectomy, along with review of the literatures.