Spontaneous Resolution of Multiple Fundic Gland Polyps after Cessation of Treatment with Omeprazole / 대한소화기학회지

Fundic gland polyps (FGPs) are the most common type of gastric polyps, found primarily in the fundus and body of stomach. Long term use of proton pump inhibitor (PPI) is known to be associated with certain histological changes of the normal gastric mucosa including parietal cell hyperplasia and fundic gland cysts. We experienced a patient who showed spontaneous resolution of multiple FGPs after the cessation of omeprazole. Two years ago, the patient showed only endoscopically confirmed erosive esophagitis without FGPs. Multiple FGPs developed one year after the use of omeprazole and spontaneously disappeared with the cessation of omeprazole.

A Case of Dysphagia Lusoria Caused by an Aberrant Right Subclavian Artery in an Adolescent / 대한소화기내시경학회지

Dysphagia lusoria is used to describe the symptomatic compression of the esophagus from an anomalous vessel of the aortic arch. A right aortic arch with an aberrant left subclavian artery is the most common type of aortic arch abnormalities, followed by double aortic arch, and then an aberrant right subclavian artery. These anomalous vessels may cause dysphagia from the compression of the esophagus in adults, but they usually do not produce symptoms and they are usually found incidentally. Several cases of adult dysphagia lusoria have been reported in Korea, but there has been no reported case in an adolescent. We experienced a case of a 17-year-old female who suffered from dysphagia. We evaluated the possible causes of her dysphagia by performing esophagogastroduodenoscopy, esophagoraphy, esophageal manometry and chest computed tomography. We finally diagnosed this case as dysphagia lusoria caused by an aberrant right subclavian artery.

Endoscopic Resection of a Pedunculated Colonic Leiomyoma Resembling a Hyperplastic Polyp / 대한소화기내시경학회지

Colonic leiomyoma is a rare condition that accounts for 3% of all gastrointestinal leiomyomas. Many colonic leiomyomas are found incidentally and are sometimes confused with epithelial neoplasms. Most leiomyomas are removed surgically. However, a small peduculated leiomyoma can be removed endoscopically as it has the appearance of an adenomatous polyp. A 54 year-old man underwent a colonoscopic examination due to frequent loose stools. Colonoscopy demonstrated the presence of a small reddish polyp with a short stalk in the sigmoid colon. We performed a successful polypectomy by the use of colonoscopic snare electrocauterization. A pathological examination revealed the presence of a leiomyoma originating in the muscularis mucosa. We report a case of a small peduculated leiomyoma that was removed endoscopically, with a review of the literature.

A case of arteriovenous fistula with drainage into the coronary sinus during the percutaneous tranluminal coronary angioplasty of chronic total occlusion of circumflex coronary artery / 대한내과학회지

Percutaneous transluminal coronary angioplasty of chronic total coronary artery occlusions are at a high risk of failure and complication. We report a case of arteriovenous fistula with drainage into the coronary sinus during the percutaneous transluminal coronary angioplasty of the chronic total occlusion of circumflex coronary artery. We think that the arteriovenous fistula of this case was occurred by the guide wire- induced trauma. But after 20-30 minutes later, the injection of contrast no longer detectd arteriovenous fistula. Later we recommended coronary artery bypass graft surgery to the patient, but he refused. Thereafter he received conservative treatment and dyspnea, chest pain were improved.

A Case of Pleural Aspergillosis / 결핵및호흡기질환

Aspergillus species cause a wide spectrum of diseases in humans and most frequent site of infection is lung. Pleural aspergillosis is a rare disease with only 3 cases having been in Korea. It may occur as a complication of tuberculosis, especially after pneumonectomy for this condition, or rupture of cavitary pulmonary aspergillosis into the pleura. We report a patient with pleural aspergillosis who showed a clinical improvement with antifungal therapy.

A Case of the Milk-alkali Syndrome During Management of Idiopathic Hypoparathyroidism / 대한내분비학회지

Idiopathic hypoparathyroidism is a relatively rare disease characterized by hypocalcemia and hyperphosphatemia: this is due to a deficiency or a sereretory disorder of the parathyroid hormone without any prior operation nor underlying medical disoder. Calcium carbonate and vitamin D substitution are generally considered as the mainstay of therapy, but these treatments can cause hypercalcemia and hypercalciuria. Persistent ingestion of large amount of calcium carbonate can cause milk-alkali syndrome that is characterized by hypercalcemia, metabolic alkalosis and renal failure. Once a patient is diagnosed with milk-alkali syndrome, withdrawal of calcium carbonate and vitamin D is essential and treatment with saline diuresis and furosemide is the usually effective. In treatmenf of hypoparathyroidism with calcium carbonate and vitamin D substitution, evaluation of serum calcium and urinary calcium excretion is essential to avoid hypercalcemia and ypercalciuria. We concluded that during treatment with calcium carbonate and vitamin D substitution for patients with idiopathic hypoparathyroidism, they should have carefully laboratory monitoring, and they should be made aware of the circumstances influencing calcium metabolism

A Case of the Milk-alkali Syndrome During Management of Idiopathic Hypoparathyroidism / 대한내분비학회지

Idiopathic hypoparathyroidism is a relatively rare disease characterized by hypocalcemia and hyperphosphatemia: this is due to a deficiency or a sereretory disorder of the parathyroid hormone without any prior operation nor underlying medical disoder. Calcium carbonate and vitamin D substitution are generally considered as the mainstay of therapy, but these treatments can cause hypercalcemia and hypercalciuria. Persistent ingestion of large amount of calcium carbonate can cause milk-alkali syndrome that is characterized by hypercalcemia, metabolic alkalosis and renal failure. Once a patient is diagnosed with milk-alkali syndrome, withdrawal of calcium carbonate and vitamin D is essential and treatment with saline diuresis and furosemide is the usually effective. In treatmenf of hypoparathyroidism with calcium carbonate and vitamin D substitution, evaluation of serum calcium and urinary calcium excretion is essential to avoid hypercalcemia and ypercalciuria. We concluded that during treatment with calcium carbonate and vitamin D substitution for patients with idiopathic hypoparathyroidism, they should have carefully laboratory monitoring, and they should be made aware of the circumstances influencing calcium metabolism

A Case of Typhoid Fever Complicated with Massive Fatal Hemoptysis / 감염과화학요법

We experienced a 25 year-old male patient with typhoid fever complicated with massive hemoptysis. Pulmonary complication in typhoid fever is very rare and to our knowledge, there has been no report of hemoptysis as a main cause of death with this disease. We herein report a rare case of typhoid fever.

A Case of Typhoid Fever Complicated with Massive Fatal Hemoptysis / 감염과화학요법

We experienced a 25 year-old male patient with typhoid fever complicated with massive hemoptysis. Pulmonary complication in typhoid fever is very rare and to our knowledge, there has been no report of hemoptysis as a main cause of death with this disease. We herein report a rare case of typhoid fever.

A case of mixed prolactin and growth hormone-secreting pituitary microadenoma presenting galactorrhea / 대한내과학회지

We report a case of galactorrhea with acromegaly from the mixed prolactin and GH secreting pituitary microadenoma managed with a successful surgical complete removal. A 31-year-old woman visited our hospital complaining galactorrhea for more than 6 months after delivery. The physical findings of the patient were a prominent galactorrhea and mild acromegalic features of face and extremities. The laboratory findings of hematology and blood chemistry were normal. In addition, the basal levels of prolactin and GH were slightly elevated. The thyroid is in euthyroid state. The results of the combined anterior pituitary hormone-stimulation tests were that the prolactin and GH responses were stimulated exaggeratedly and the other hormonal ones were normal responses. The oral glucose loading test for acromegaly revealed non-responder results. The sellar MRI showed the 6 X 5 mm-sized pituitary microadenoma. She was operated for surgical removal of the lesions of which the immunohistochemistry findings were consistent with the positive findings for both prolactin and GH. She discharged without post-operative complication and has done well with normalized hormonal levels at outpatient department.