Evaluation of Characteristics of the Dental Maturity in Girls with Precocious Puberty / 대한소아치과학회지

Precocious puberty (PP) is defined as the early development of secondary sexual characteristics (before the ages of 8 years in girls and 9 years in boys). The aim of this study is to identify characteristics of the dental maturity in girls with PP that discriminate them from normal healthy girls. This study included 99 girls aged 6 - 8 years with PP and 99 girls without past medical history of same chronological age (control group). The study was performed on 198 panoramic radiographs (99 PP girls, 99 control group girls). Demirjian method was used to evaluate the panoramic radiographs and determine dental maturity. Difference in dental maturity score and tooth formation stages between the two groups were analyzed. The PP group showed significant higher maturity score than control group. Among mandibular teeth, mandibular 2nd premolar and 2nd molar were significantly more mature in the PP group than control group. Logistic regression analysis showed that mandibular 2nd molar was only significant predictor for PP girls.

Visual Outcome and Patient Satisfaction after Implantation of Multifocal IOLs: Three-Month Follow-Up Results

PURPOSE: To evaluate the visual outcome and patient satisfaction at three months after implantation of ReSTOR(R) Aspheric multifocal IOL D1 (+3.0 D) and D3 (+4.0 D) in unilateral and bilateral cataract surgery groups. METHODS: Among 73 patients who received cataract surgery and implantation of D1 or D3, visual outcome and satisfaction score of 34 patients in the unilateral surgery group and 39 patients in the bilateral surgery group were analyzed respectively. The unilateral surgery group was divided into 2 sub-groups (D1, D3), and the bilateral surgery group was sub-divided into 3 groups (D1/D1, D1/D3, D3/D3) according to the combination of implanted IOL. Uncorrected near visual acuity (UNVA, 30 cm), uncorrected intermediate visual acuity (UIVA, 40 cm, 50 cm), uncorrected distant visual acuity (UDVA) and best corrected visual acuity (BDVA) were measured at three months postoperatively. Also, all patients answered questionnaires to assess satisfaction. RESULTS: In the unilateral surgery sub-groups, visual acuity of the D1 group was higher than that of the D3 group at 50 cm (p < 0.001), although the D3 group showed better visual outcome at 30 cm (p < 0.001). In satisfaction analysis, the D1 group reported significantly higher scores in three categories (general satisfaction with surgery; p = 0.027, intermediate vision; p < 0.001, recommendation to others; p = 0.026). Among the bilateral surgery groups, the D1/D1 group showed the best intermediate visual acuity at 50 cm (p = 0.011), and the D3/D3 group achieved the highest postoperative near visual acuity (p = 0.004). In satisfaction analysis, the scores of the three categories (general satisfaction with surgery; p = 0.008, intermediate vision; p < 0.001, recommendation to others; p = 0.006) showed significant differences among the three groups, with the D1/D1 group reporting the highest scores in all three categories. CONCLUSIONS: In bilateral ReSTOR(R) lens implantation, insertion of D1 in both eyes is expected to achieve the most favorable visual outcome and patient satisfaction. In unilateral ReSTOR(R) lens implantation, implantation of D1 rather than D3 would be more advantageous in general.

A Case of Successful Colonoscopic Treatment of Colonic Obstruction Caused by Phytobezoar

A phytobezoar is the most common type of bezoar, which is a gastrointestinal mass composed of vegetable. A persimmon is a common cause of a phytobezoar. The majority of bezoars are found in the stomach, with the small intestine being the next most commonly involved site. The colon is a rare site for a bezoar. Recently, we experienced a colonic bezoar that caused colonic obstruction in a 66-year-old female patient who took persimmons regularly. The patient came to the hospital because of abdominal pain and distension. To differentiate a tumor or other problems that can cause intestinal obstruction, we performed an abdominal computed tomography scan and found an ovoid intraluminal mass with a mottled gas pattern in the distal descending colon. A large impacted bezoar was seen in the sigmoid colon, which was completely obstructed, and it was successfully removed by using colonoscopy.

Investigation of Sarcopenia and Its Association with Cardiometabolic Risk Factors in Elderly Subjects

BACKGROUND: The aim of this study was to investigate sarcopenia and its association with cardiometabolic risk factors in a community-based elderly cohort in Korea. METHODS: We recruited 287 men and 278 women aged 65 years or older and without physical disability. Appendicular skeletal muscle mass (ASM) was measured with dual energy X-ray absorptiometry. We used two definitions for sarcopenia-ASM divided by height2 (kg/m2) or by weight (%) <1 SD below the sex-specific mean for young adults. We compared RBP-4, adiponectin, hsCRP, lipid profiles, and insulin resistance between the sarcopenic and normal groups using ASM/Ht2 and ASM/Wt. RESULTS: The prevalence of sarcopenia was 35.3% in men and 13.4% in women with sarcopenia defined by ASM/Ht2. However, it was 38.3% in men and 62.6% in women by ASM/Wt. In correlation analysis, body mass index was positively correlated with ASM/Ht2 and negatively correlated with ASM/Wt. The sarcopenic group, when defined as ASM/Ht2, showed lower RBP4, fasting plasma glucose, and HOMA-IR and higher adiponectin than the normal group but not significantly different lipid profiles. The sarcopenic group defined by ASM/Wt had higher RBP4, fasting plasma glucose, and HOMA-IR, and lower adiponectin than the normal group in both sexes. Only in the males did the sarcopenic group defined by ASM/Wt reveal higher total cholesterol, triglycerides, and LDL cholesterol, and lower HDL cholesterol than the normal group. CONCLUSION: In conclusion, the sarcopenic group defined by ASM/Wt was more closely associated with cardiometabolic risk factors than the normal group in a community-based elderly cohort.

Subclinical Coronary Artery Disease as Detected by Coronary Computed Tomography Angiography in an Asymptomatic Population

BACKGROUND AND OBJECTIVES: Primary prevention of coronary artery disease (CAD) has become a public health issue, according to increasing awareness of the substantial risks posed by asymptomatic atherosclerosis. The aims of this study were to determine the prevalence and characteristics of subclinical CAD using coronary computed tomography angiography (CCTA), and to evaluate the role of this advanced technology in identifying subclinical CAD in asymptomatic Korean individuals, compared with conventional risk stratification. SUBJECTS AND METHODS: We enrolled 4,320 consecutive asymptomatic individuals (61% males, aged 50+/-9 years), who underwent 64-slice CCTA during a routine health check. RESULTS: Coronary artery plaques were present in 1,053 (24%) individuals. Significant stenosis (diameter stenosis > or =50%) was identified in 139 (3%) subjects, and most of the significant lesions (87%) were located in the left anterior descending artery. CCTA revealed noncalcified plaques in 5% of subjects with a coronary calcium score of zero (n=801). Although 25% (n=10) of those with noncalcified plaque had significant stenosis, most of them (90%) were classified into low- or moderate-risk groups according to National Cholesterol Education Program risk stratification guidelines. In a young population (age < or =55 years for males, < or =65 years for females), 30% of subjects with significant stenosis were classified into a low-risk group and 60% had low (0 to 100) calcium scores. CONCLUSION: Subclinical CAD in asymptomatic individuals cannot be ignored for its considerable prevalence, CCTA may be helpful in identifying at-risk subclinical CAD in a noninvasive manner, especially in the young and traditionally low-risk population.

A Case of Degos' Disease Presenting with Abdominal Angina and Widespread Skin Lesions

Malignant atrophic papulosis (MAP), also known as Degos' disease, is a rare and often fatal occlusive thrombotic vasculopathy, with fewer than seven cases reported in Korea. MAP is characterized by porcelain-white, atrophic, papular skin lesions and multi-organ system involvement, especially the gastrointestinal (GI) tract and nervous system. Involvement of the GI tract is usually associated with a poor prognosis. To date, no treatment has been shown to be effective in the treatment of MAP. We describe a 52-year-old man who presented with a 5-month history of abdominal angina and a 2-year history of multiple skin lesions on the trunk and extremities. The skin lesions were papules, 4-6 mm in diameter, with a porcelain-white center and a slightly raised erythematous telangiectatic rim. A biopsy of a skin lesion showed a wedge-shaped degeneration of collagen in the dermis and atrophic epidermis. An explorative laparoscopy revealed multiple, yellow-white plaques scattered throughout the small bowel. A biopsy of the small bowel showed sclerotic vascular alterations containing intravascular fibrin thrombi. He was started on aspirin (100 mg daily) and has survived for 24 months since the onset of gastrointestinal symptoms.

A Case of Degos' Disease Presenting with Abdominal Angina and Widespread Skin Lesions

Malignant atrophic papulosis (MAP), also known as Degos' disease, is a rare and often fatal occlusive thrombotic vasculopathy, with fewer than seven cases reported in Korea. MAP is characterized by porcelain-white, atrophic, papular skin lesions and multi-organ system involvement, especially the gastrointestinal (GI) tract and nervous system. Involvement of the GI tract is usually associated with a poor prognosis. To date, no treatment has been shown to be effective in the treatment of MAP. We describe a 52-year-old man who presented with a 5-month history of abdominal angina and a 2-year history of multiple skin lesions on the trunk and extremities. The skin lesions were papules, 4-6 mm in diameter, with a porcelain-white center and a slightly raised erythematous telangiectatic rim. A biopsy of a skin lesion showed a wedge-shaped degeneration of collagen in the dermis and atrophic epidermis. An explorative laparoscopy revealed multiple, yellow-white plaques scattered throughout the small bowel. A biopsy of the small bowel showed sclerotic vascular alterations containing intravascular fibrin thrombi. He was started on aspirin (100 mg daily) and has survived for 24 months since the onset of gastrointestinal symptoms.

Notice of duplicate publication

No abstract available.

Clinical Significance and Outcomes of Initial No Growth Peritonitis from Peritoneal Dialysis Patients: Role of Mycobacterial or Fungal Peritonitis / 대한신장학회지

PURPOSE: Peritoneal dialysis associated peritonitis (PD peritonitis) is an important complication in maintaining. There have been only a few reports on the clinical outcome of initial no-growth peritonitis (INGP). METHODS: We reviewed 332 episodes of PD peritonitis between January 2002 and August 2009. INGP was defined as PD peritonitis with no growth of etiologic microorganism within 3 days of peritonitis. INGP was compared with initial positive growth peritonitis (IPGP) in view of clinical manifestations and outcomes. RESULTS: We divided PD peritonitis episodes into two groups: INGP (n=90) and IPGP (n=242). Peritonitis-related mortality was 5.6% in INGP, while 0.8% in IPGP (p=0.017). Further relapse was noted in INGP (10.0%) than in IPGP (vs. 4.1%; p=0.041). Salvage antibiotics were used more frequently in INGP (21.1%) than in IPGP (vs. 11.6%; p=0.027). Odds ratio of INGP to IPGP for peritonitis-related mortality was 7.14 (95% CI 1.36-37.51; p=0.017). Growth of mycobacteria or fungi increased the risk of peritonitis-related mortality with an odds ratio of 18.11 (95% CI 2.99-109.89; p=0.013). In multivariate analysis, growth of mycobacteria or fungi was the only independent risk factor for peritonitis-related mortality with an odds ratio of 10.63 (95% CI 1.27-88.75; p=0.029). CONCLUSION: INGP revealed poorer outcome than IPGP. Higher growth rate of mycobacteria or fungi in INGP than in IPGP accounted for the poor outcome. Thus one should make vigorous efforts to detect surreptitious organism when there is no growth by 3 days, especially for the possibility of either mycobacteria or fungi.

A Case of Endometriosis with Chylous Ascites / 대한소화기내시경학회지

Chylous ascites is the extravasation into the peritoneal cavity of milky chyle that is rich in triglycerides. Sixty to seventy percent of chylous ascites cases are caused by cirrhotic liver disease, congestive heart failure, or malignancy. The most common malignancy associated with chylous ascites is lymphoma. Rarely, tuberculosis has been reported as a cause of chylous ascites. Appropriately, lymphoma, ovarian cancer or tuberculosis is considered first in the differential diagnosis when a young woman of reproductive age presents with chylous ascites. Recently, we examined a 26-year-old woman who visited our hospital because of abdominal distension. Ascites tapping, esophagogastroduodenoscopy, colonoscopy and diagnostic laparoscopic biopsy led to a diagnosis of intraperitoneal endometriosis with chylous ascites. To date, some cases of endometriosis complicated by massive ascites have been reported. However, endometriosis complicated by chylous ascites has not been previously reported. The case was successfully treated using a gonadotropin-releasing hormone agonist and diuretics.

A Case of Inferior Vena Cava Thrombosis and Acute Pancreatitis in a Patient with Ulcerative Colitis / 대한소화기학회지

A 21-year-old man admitted complaining of sudden severe epigastric pain for 1 day. He had been diagnosed as ulcerative colitis (UC) and taking mesalazine for two months. UC was in nearly complete remission at admission. He never drank an alcohol, and serum amylase was 377 IU/L. CT scan showed inferior vena cava (IVC) thrombosis in addition to mild acute pancreatitis. To evaluate the cause of acute pancreatitis and IVC thrombosis, magnetic resonance cholangiopancreatogram (MRCP), endoscopic ultrasonogram (EUS), lower extremity Doppler ultrasonogram (US) and blood test of hypercoagulability including factor V, cardiolipin Ab, protein C, protein S1, antithrombin III, and anti phospholipids antibody were performed. There was no abnormality except mild acute pancreatitis and IVC thrombosis in all the tests. He was recommended to stop taking mesalazine and start having anticoagulation therapy. After all symptoms disappeared and amylase returned normal, rechallenge test with mesalazine was done. Flare-up of abdominal pain occurred and the elevation of serum amylase was observed. Ulcerative colitis came to complete remission with short-term steroid monotherapy. Acute pancreatitis and IVC thrombosis were completely resolved after 3-month anticoagulation therapy with no more mesalazine. We postulated that IVC thrombosis occurred due to hypercoagulable status of UC and intra-abdominal inflammation caused by mesalazine-induced pancreatitis.

Evaluation of Osteoporotic Vertebral Bone and Disc Degeneration Induced by Malnutrition during Growth Period: Biomechanical and Histomorphometrical Study / 체질인류학회지

The aim of the present study is to analyze the generation of osteoporotic vertebral bone induced by malnutrition during growth period and analyze its effects for disc degeneration, based on biomechanical and histomorphometrical study. Mechanical and histomorphological characteristics of lumbar vertebral bones and discs of rats with calcium free diet (CFD) were detected and tracked by using high resolution in-vivo micro-computed tomography (in-vivo micro-CT), finite element (FE) and histological analysis. Twenty female Sprague-Dawley rats (6 weeks old, approximate weight 170g) were randomly divided into two groups (CFD group: 10, NOR group: 10). The CFD group was maintained on a refined calcium-controlled semisynthetic diet without added calcium, to induce osteoporosis. All lumbars (L1~L6) were scanned by using in vivo micro-CT with 35 micrometer resolution at 0, 4, 8 weeks to track the effects of CFD on the generation of osteoporosis. The results of morphological characteristics showed that BV/TV, Tb.Th, Tb.N in CFD group were significantly decreased over time (p<0.05), while those in NOR group were statistically increased over time (p<0.05) in the most lumbars (L1~L6). We also investigated the contrary tendency in Tb.Sp and SMI, compared to the above results in each group. In the simulated compression test using FE models, the structural effective modulus of CFD group significantly decreased (p<0.05), whereas that of NOR group was statistically increased, depending on the measuring time (p<0.05). The present study observed remarkable histological changes of nucleus pulposus and annulus fibrous by water loss in CFD group, compared with NOR group. These findings indicated that calcium insufficiency was the main factor in the generation of osteoporosis and it induced lumbar vertebral disc degeneration. This study is a valuable experiment to firstly evaluate osteoporotic vertebral bone and disc degeneration induced by malnutrition during growth period from a biomechanical and histomorphometrical point of view.

Mechanical Properties of Blood-mixed PMMA in Percutaneous Vertebroplasty / 대한척추외과학회지

STUDY DESIGN: This is a mechanical study of polymethylmetacrylate(PMMA) mixed with blood as a filler. OBJECTIVE: We tried to change the properties of PMMA so that it is more suitable to use for percutaneous vertebroplasty (PVP). SUMMARY OF THE LITERATURE REVIEW: The mechanical changes by adding a filler into PMMA were expected to decrease the Young's modulus, the polymerization temperature and the setting time. These changes of PMMA were considered to be more suitable and adaptable conditions for PVP for treating osteoporotic vertebral compression fracture. MATERIALS AND METHODS: Porous PMMA was produced by mixing 2 ml (B2), 4 ml (B4) and 6 ml (B6)-blood as a filler, and the mechanical properties were investigated in comparison with regular PMMA(R) in view of Young's modulus, the polymerization temperature, the setting time and the optimal passing-time within the injectable viscosity (20~50N-needed) through a 2.8mm-diameter cement-filler tube. Porosity was inspected by performing microcomputated tomography (micro-CT). RESULTS: Young's modulus was decreased from 919.5 MPa (R) to 701 MPa (B2), 693.5 MPa (B4) and 545.6 MPa (B6) in each group. The polymerization temperature decreased from 74.2degrees C (R) to 59.8degrees C (B2), 54.2degrees C (B4) and 47.5degrees C(B6), respectively. The setting time decreased from 1065sec (R) to 624sec (B2), 678sec(B4) and 606sec (B6), respectively, and the optimal passing-time decreased from 75.6sec (R) to 46.6sec (B2), 65.0sec (B4) and 79.0sec(B6), respectively. The porosity increased from 4.2%(R) to 27.6%(B2), 27.5%(B4) and 29.5%(B6), respectively. A homogenous microstructure with very fine pores was seen on inspection of all the blood-mixed PMMAs. CONCLUSION: Blood mixed with PMMA was considered as an excellent filler that was easy to make and had good biocompatibility. The 6ml blood-mixed PMMA (B6) showed more suitable mechanical properties, including a decreased elastic modulus due to more porosity, less heating and a retarded optimal passing-time by the serum barrier, which diminished the friction between the PMMA and a cement-filler tube.

Mechanical Properties of Blood-Mixed Polymethylmetacrylate in Percutaneous Vertebroplasty

STUDY DESIGN: Mechanical study of polymethylmetacrylate (PMMA) mixed with blood as a filler. PURPOSE: An attempt was made to modify the properties of PMMA to make it more suitable for percutaneous vertebroplasty (PVP). OVERVIEW OF LITERATURE: The expected mechanical changes by adding a filler into PMMA included decreasing the Young's modulus, polymerization temperature and setting time. These changes in PMMA were considered to be more suitable and adaptable conditions in PVP for an osteoporotic vertebral compression fracture. METHODS: Porous PMMA were produced by mixing 2 ml (B2), 4 ml (B4) and 6 ml (B6) of blood as a filler with 20 g of regular PMMA. The mechanical properties were examined and compared with regular PMMA(R) in view of the Young's modulus, polymerization temperature, setting time and optimal passing-time within an injectable viscosity (20-50 N-needed) through a 2.8 mm-diameter cement-filler tube. The porosity was examined using microcomputed tomography. RESULTS: The Young's modulus decreased from 919.5 MPa (R) to 701.0 MPa (B2), 693.5 Mpa (B4), and 545.6 MPa (B6). The polymerization temperature decreased from 74.2degrees C (R) to 59.8degrees C (B2), 54.2degrees C (B4) and 47.5degrees C (B6). The setting time decreased from 1,065 seconds (R) to 624 seconds (B2), 678 seconds (B4), and 606 seconds (B6), and the optimal passing-time decreased from 75.6 seconds (R) to 46.6 seconds (B2), 65.0 seconds (B4), and 79.0 seconds (B6). The porosity increased from 4.2% (R) to 27.6% (B2), 27.5% (B4) and 29.5% (B6). A homogenous microstructure with very fine pores was observed in all blood-mixed PMMAs. CONCLUSIONS: Blood is an excellent filler for PMMA. Group B6 showed more suitable mechanical properties, including a lower elastic modulus due to the higher porosity, less heating and retarded optimal passing-time by the serum barrier, which reduced the level of friction between PMMA and a cement-filler tube.

Correlation Between Preoperative OCT Pattern and Visual Improvement in Macular Epiretinal Membrane

PURPOSE: To analyze the correlation between preoperative characteristics of optical coherence tomography (OCT) image and visual improvement in macular epiretinal membrane (ERM) and to determine whether preoperative difference upon OCT pattern is a prognostic indicator of high postoperative visual acuity. METHODS: We retrospectively reviewed the records of 99 patients (100 eyes) with ERM, who were treated by vitrectomy and followed for more than four months. We classified the OCT images of preoperative ERM into three different types: flat macula, convex macula, and concave macula. Then we compared the preoperative visual improvement among the three types. RESULTS: The causes of ERM were idiopathic in 59 eyes, diabetic retinopathy in 16 eyes, uveitis in 9 eyes, and retinal vein occlusion in 6 eyes. The types of OCT were flat macula in 30 eyes, convex macula in 62 eyes, and concave macula in 8 eyes. The grades of visual improvement of LogMAR (logarism of minimum angle of resolution) were 0.49, 0.48, and 0.46, respectively. All three groups showed a significant level of visual improvement. In the secondary ERM group, preoperative and postoperative Log MAR of convex macula revealed lower preoperative and postoperative visual acuity than that of the flat and concave macula (P<0.05). There was a higher degree of visual improvement in patients with pseudophakia, but preoperative central macular thickness (CMT) and the presence of internal limiting membrane (ILM) peeling were not corrected with visual improvement. CONCLUSIONS: This study demonstrated that vitrectomy for epiretinal membrane resulted in favorable visual improvement. There is no correction between preoperative morphologic difference upon OCT and the degree of visual improvement in ERM.

A case of clopidogrel induced neutropenia / 대한내과학회지

Clopidogrel is an oral agent that blocks ADP receptor-mediated platelet aggregation. Clopidogrel along with aspirin was shown by the CURE trial to result in a 20% relative reduction of cardiovascular death, myocardial infarction or stroke. Ticlopidine has been shown to reduce the incidence of stent thrombosis compared with warfarin, but it may cause serious hematological side effects. However, the reported neutropenia has been similar to clopidogrel and aspirin treatment groups (0.01 vs 0.17%, respectively) with corresponding rates (0.05 vs 0.04%, respectively) of severe neutropenia. We treated a 72-year-old female patient with severe neutropenia who underwent percutaneous coronary intervention with drug-eluting stent placement and had no neutrophils in the peripheral blood at 11 days after clopidogrel use. Therefore, clinicians should be alerted to the possibility of severe neutropenia with clopidogrel treatment.

A Case of Esophageal Tuberculous Abscess / 대한소화기내시경학회지

Primary esophageal involvement by tuberculosis is rare. Clinical symptoms are variable and nonspecific in which dysphagia is the most common presenting symptom. Endoscopic findings are also diverse and nonspecific and ulcerative form is a common manifestation. For a definite diagnosis, Endoscopic biopsies are useful but typical granuloma is seen in approximately 50% of cases and acid-fast bacilli are demonstrated in less than 25% of patients. Fine needle aspiration cytology and polymerase chain reaction are helpful for diagnosis. A 54-year-old man was presented with throat discomport. Endoscopy demonstrated hematoma like lesion with pus discharge from ulceration in the proximal esophagus. Esophageal tuberculosis was confirmed based on the biopsy and culture results, and he was treated with antituberculous medications. At the follow-up endoscopy, 6 months later, previous lesion was completely healed to scar.

A Case of Hepatic Angiosarcoma Presenting as Submucosal Tumor Resulting from Gastric Invasion / 대한소화기내시경학회지

Angiosarcoma accounts for 1% of all soft tissue sarcoma. Common sites of occurrence include the skin, breast, soft tissue, and liver. It metastasizes to the lungs, bone, and spleen. The cause of hepatic angiosarcoma in the 60% of cases is unknown, although specific risk factors such as vinyl chloride, arsenic, thorotrast and external-beam irradiation have been identified. Since 1986, about eight cases of hepatic angiosarcoma have been reported in Korea, but it had not been reported in which the hepatic angiosarcoma invaded to the stomach, yet. So we report a case of histopathologically confirmed primary hepatic angiosarcoma with gastric involvement. In this case, a sixtythree-year-old female was presented with indigestion and epigastric soreness for 1 year. Endoscopic examination of the stomach revealed a submucosal tumor-like protruding mass from the antrum to angle. The mucosal surface showed severe hyperemia and shallow ulcerative change was seen. Endoscopic biopsy and percutaneous liver biopsy confirmed the diagnosis of hepatic angiosarcoma invading the gastric wall.

A Case of Boerhaave's Syndrome after Bowel Preparation with Polyethylene Glycol / 대한소화기내시경학회지

Polyethylene glycol (Colyte(R)) electrolyte lavage solution is widely used for bowel preparataion before colonoscopy and surgery. The minor complications associated with PEG solution, i.e., nausea and bloating have been reported on. However, major complications such as PEG electrolyte lavage solution-induced Mallory-Weiss tear, esophageal rupture, asystole and aspiration have rarely been reported on. Spontaneous rupture of the esophagus (Boerhaave's syndrome) is a very rare disease and it is often diagnosed late or it is misdiagnosed because of the atypical clinical symptoms. Its mortality increases proportionally to the time between esophageal rupture and treatment. It can cause a fatal outcome unless it is treated early. We authors report here on a case of spontaneous esophageal rupture after bowel preparation with polyethylene glycol.

A Case Of Low Grade B Cell Mucosa Associated Lymphoid Tissue Lymphoma Of Jejunum Presenting Recurrent Lower Gastrointestinal Bleeding And Perforation / 대한내과학회지

The accurate diagnosis and localization of gastrointestinal bleeding may use many tests and procedures including serial hematocrits, angiography, scintigraphy, endoscopy, nasogastric aspiration, barium studies and surgery before success is achieved. However, lower gastrointestinal (GI) bleeding is difficult to localize despite above diagnostic procedures. We had experienced a case of mucosa associated lymphoid tissue (MALT) lymphoma of jejunum. In this case, a 61-year-old male was admitted to our hospital with recurrent lower GI bleeding. The cause of recurrent lower GI bleeding was not defined by extensive evaluation including gastrofiberoscopy, colonoscopy, mesenteric angiography, small bowel series. We diagnosed this case as low grade B cell MALT lymphoma after exploratory laparatomy due to bowel perforation.