Three cases of right coronary anomaly confirmed by multi-detector computed tomography / 대한내과학회지

Congenital anomaly of the right coronary artery is a very rare disease. It can cause syncope, angina pectoris, acute myocardial infarction, ventricular fibrillation and sudden cardiac death during exercise in the young population. The dominancy of the coronary artery, and the site, shape and pathway of the right coronary artery seems to play a key role in developing those above mentioned events. Especially, it has been known that the right coronary artery that courses between the aorta and pulmonary trunk increases the risk of sudden death. Therefore, precise evaluation is needed to diagnose the presence and type of coronary artery anomaly. Nowadays, multi-detector computed tomography is used to diagnose coronary anomalies and this provides clear images of coronary anomaly in a safe and noninvasive way. We report here on three cases of right coronary anomaly that coursed between the aorta and pulmonic trunk, and this was confirmed by multi-detector computed tomography.

A Case of Choledochal Cyst (Type IVa) and Anomalous Pancreaticobiliary Ductal Union Combined with Pancreatic Duct Stone / 대한소화기내시경학회지

Pancreatic duct stones are commonly associated with recurrent pancreatitis. They are believed to develop as a result of the calcification of an intraductal protein plug. A choledochal cyst is a relatively rare anomaly usually presenting with abdominal pain, jaundice and palpable mass. APBDU (anomalous pancreaticobiliary ductal union) is frequently associated with various pancreatobiliary diseases, including choledochal cyst, biliary tumor, pancreatitis and pancreas divisum. We report a 48-year-old woman who presented with right upper quadrant pain with a pancreatic duct stone, a choledochal cyst and APBDU. She underwent endoscopic pancreatic sphincterotomy, a surgical choledochal cyst excision and Roux-en-Y choledochojejunostomy.

A Case of Pellagra Induced by Isoniazid during Treatment of Pulmonary Tuberculosis / 결핵및호흡기질환

A Case of Pellagra Induced by Isoniazid during Treatment of Pulmonary Tuberculosis Pellagra is a disease caused by a deficiency of nicotinic acid or niacin. It is mostly found among people eating corn-based diets in parts of China, Africa and India. It is also induced by drugs, such as isoniazid or 5-fluorouracil. Isoniazid inhibits the conversion of tryptophan to niacin and may induce pellagra, particularly in poorly nourished patients. Pellagra should be suspected whenever tuberculous patients under the treatment with isoniazid develop mental, neurological or gastrointestinal symptoms, even in the absence of typical skin changes. Herein, our experienced of a case of pellagra induced by isoniazid during treatment of pulmonary tuberculosis is reported. The patient was referred due to a skin rash and drowsy mental status. Her skin lesion developed during treatment for pulmonary tuberculosis. Her symptoms were improved after discontinuation of antituberculous agents and on the administration of nicotinamide.