A Case of Atypical Solid-pseudopapillary Tumor of the Pancreas / 대한소화기학회지

Solid-psudopapillary tumor is an uncommon pancreatic neoplasm of low malignant potential that most frequently affect young woman. Solid-psudopapillary tumor are histologically, clinically, and prognostically quite distinct from the more common ductal adenocarcinoma. Recently, we experienced a 36-year-old male who was suspected to have extrapancreatic tumor based on atypical radiologic imaging study, young age, and male sex, and finally diagnosed as solid-psudopapillary tumor on immunohistochemical stain examination. We report this case with review of the relevant literatures.

A case of infective endocarditis in active Crohn's disease / 대한내과학회지

Crohn's disease is a condition of chronic inflammation potentially involving any location of the alimentary tract, from the mouth to the anus. Numerous extraintestinal manifestations also may be present. Inflammatory bowel disease may be considered an independent risk factor for infective endocarditis. Reasons for endocarditis may be more frequent bacteremia because of the higher incidence of diagnostic and therapeutic interventions, as well as an increased permeability of the damaged mucosa for bacteremia and therapeutic immunosuppression in patients with active inflammatory bowel disease. We report here a case of a 22-year old male who was diagnosed with infective endocarditis in active Crohn's disease. This is the first case report in Korea of this diagonsis.

A Case of Esophageal Anisakiasis Presenting as Chest Pain Mimicking Angina / 대한소화기내시경학회지

Chest pain of a non-cardiac origin is frequently seen in medical practice. This kind of chest pain is often difficult to differentiate from chest pain of a cardiac origin. Esophageal anisakis is a rare finding, but it can cause chest pain. We report here on a patient who had a history of acute myocardial infarction and who also had one stent inserted in his left anterior descending coronary artery two month previously. The patient presented with substernal chest pain that mimicked anginal chest pain. Endoscopic examination revealed a whitish linear worm that had had invaded the esophagogastric junction, and we removed the worm with biopsy forceps. We report here on a patient with an esophageal anisakiasis as a rare cause of noncardiac chest pain that mimicked anginal chest pain.

A Case of Non-Hodgkin's Lymphoma in a Patient with Crohn's Disease / 대한소화기학회지

Although adenocarcinoma is a well known complication of chronic inflammatory bowel disease, primary gastrointestinal lymphoma occurring in Crohn's disease is rare. A 40-year-old man with 10 year-history of Crohn's disease had multiple longitudinal ulcerative lesions on descending colon in follow-up colonoscopic examination. Microscopic examination of proximal descending colon revealed peripheral T cell lymphoma and other site of the descending colon was consistent with Crohn's disease. The patient reached complete remission of malignant lymphoma after three cycles of combined chemotherapy. He has been well for 10 months with sulfasalazine maintenance therapy but was admitted to the hospital due to spontaneous bowel perforation of ascending colon. Right hemicolectomy was done, but the patient died of post-surgical recurrent mesenteric abscess and sepsis. To the best of our knowledge, this is the first case of Non-Hodgkin's lymphoma complicating Crohn's disease in Korea which was confirmed by immunohistochemical studies.

Hearing Difficulty According To Traumatic Disk Displacement: A Case Report

The Effect of Positive end Expiratory pressure on the Pulmonary Capillary Pressure in Acute Lung Injury Patients / 결핵

BACKGROUND: Positive end expiratory pressure (PEEP) ventilation is well established as an integral part of the management of patients with the acute lung injury. PEEP is a key element in the treatment of hypoxemia resulting from pulmonary edema. Pulmonary capillary pressure (Pcap) is the most important factor influencing lung edema formation, and an understanding of how Pcap is altered by variations of PEEP or pulmonary arterial occlusion pressure (PAOP) is important to improve the treatment of acute lung injury patients. This study was performed to evaluate the effects of PEEP on the pulmonary capillary pressure in acute lung injury patients. METHODS: This was a prospective study of 11 acute lung injury patients. The effect of PEEP on pulmonary circulation at four different levels (0,4,8, and 12cm H2O) was analyzed. Pcap was estimated visually at bed side with Swan Ganz catheters. The pulmonary vasculature was analyzed by calculating the pressure difference at the arterial and venous parts of the circulation. RESULTS: As PEEP increased from 0 to 12 cm H2O, the mean puhnonary arterial pressure (PAP) and Pcap increased respectively from 22.7 ± 7.4 to 25.3 ± 7.3 mmHg and 15.3 ± 3.3 to 17.8 ±3.2 mmHg (p<0.05). Similarly, PAOP increased from 9.8 ± 2.1 to 12.8 ± 2.1 mmHg and the central venous pressure increased from 6.1 ± 1.6 to 9.3 1: 2.3 mmHg(p<0.05). However, the pressure gradient at the arterial (PAP-Pcap) and venous (Pcap-Pcwp) part of pulmonary circulation remained unchanged at all evaluated PEEP levels. CONCLUSION: Although Pcap increasoo gradually with increased PEEP, the pressure gradient at the arterial and venous part of the pulmonary vasculature remained unchanged at all evaluated PEEP levels in acute lung injury patients.