A Case of Solitary Gastric Neurofibroma Presenting as Hematemesis and Melena / 대한소화기내시경학회지

Gastric neurofibroma is rare and its exact incidence is unknown. We experienced a case of solitary gastric neurofibroma. A 49-year-old woman was admitted because of hematemesis and melena. Neither cafe-au-lait spots in skin nor superficial tumor were found. Gastrofibroscopic examination and UGI series showed a 3 * 4 cm sized luminal protruding mass with adjacent bridging mucosal fold and cental ulceration on the anterior wall of lower body. Mass excision was performed. Grossly, the mass was 4.5 * 3.0 * 2.0 cm sized, well circumscribed submucosal tumor with homogenous cut surface, Microscopically, each of the tumor cells had oval shaped nucleus and spindle shaped cytoplasm. Nuclear atypism and frequent mitosis were not observed. We report a rare case of solitary gastric neurofibroma with review of the literatures.

A Comparative Study of Endotracheal Aspirates and Protected Specimen Brush in the Quantitative Cultures of the Ventilator-Associated Pneumonia / 결핵

BACKGROUND: Pneumonia is a frequent complication in patients undergoing mechanical ventilation. Quantitative culture of protected specimen brush(PSB) have shown satisfactory diagnostic accuracy for the diagnosis of ventilator-associated pneumonia. However PSB method is invasive, expensive, and require a bronchoscopic procedure. But endotracheal aspiration(EA) is simple and less expensive. The purpose of our study was to investigate the diagnosic value of EA quantitative cultures. METHOD: We studied 15 cases of ventilator-associated pneumonia(for >72h of mechanical ventilation) patients. Patients were divided into two diagnostic categories. Group I was the patients who were suspicious of clinical pneumonia, Group II was the patients for control. The obtained samples by EA and PSB were homogenized for quantitative culture with a calibrated loop method in all patients. RESULT: Using 103cfu/ml, 105cfu/ml as threshold in quantitative culture of PSB, EA respectively, we found that EA quantitative cultures represented a relatively sentive(70%) and relatively specific (60%) method to diagnose the ventilator-associated pneumonia. CONCLUSION: Although EA quantitative cultures are less specific than PSB for diagnosing ventilator-associated pneumonia. EA quantitative cultures correlated with PSB quantitative culture in patients with clinical pneumonia and may be used to treat these patients when bronchoscopic procedures are not available.