Metronidazole-induced encephalopathy in a patient with liver cirrhosis / 대한간학회지

Encephalopathy is a disorder characterized by altered brain function, which can be attributed to various causes. Encephalopathy associated with metronidazole administration occurs rarely and depends on the cumulative metronidazole dose, and most patients with this condition recover rapidly after discontinuation of therapy. Because metronidazole is metabolized in the liver and can be transported by the cerebrospinal fluid and cross the blood-brain barrier, it may induce encephalopathy even at a low cumulative dose in patients with hepatic dysfunction. We experienced a patient who showed ataxic gait and dysarthric speech after receiving metronidazole for the treatment of hepatic encephalopathy that was not controlled by the administration of lactulose. The patient was diagnosed as metronidazole-induced encephalopathy, and stopping drug administration resulted in a complete recovery from encephalopathy. This case shows that caution should be exercised when administering metronidazole because even a low dose can induce encephalopathy in patients with liver cirrhosis.

A Case of Graves' Disease Following Subacute Thyroiditis / 대한내과학회지

Subacute thyroiditis is a spontaneously resolving inflammatory disease of the thyroid gland, which is usually associated with a viral infection and genetic factors. In some cases of this disorder, thyroid autoantibodies can appear, probably due to the inflammatory release of thyroid antigens, althoughtheir pathophysiological role in the course of this disease is not yet fully understood. The occurrence of Graves' disease after subacute thyroiditis is extremely rare, and only a few cases have been reported. Here, we report a case of a middle-aged woman who developed Graves' disease after subacute thyroiditis.

An Intramural Gastric Hematoma after Epinephrine Injection for Gastric Ulcer Bleeding in Patient with Liver Cirrhosis / 대한소화기내시경학회지

Intramural hematoma of the gastrointestinal tract is an uncommon occurrence with the majority being localized to the esophagus or duodenum. Hematoma of the gastric wall is very rare, and has been reported most commonly in association with coagulopathy, trauma, hematologic disease, and therapeutic endoscopy. Here we describe a case of intramural gastric hematoma after epinephrine injection therapy for a gastric ulcer with underlying liver cirrhosis that was successfully managed with conservative therapy.

Post-extubation Negative Pressure Pulmonary Edema Complicating ESD under General Anesthesia / 대한소화기내시경학회지

Negative pressure pulmonary edema is a recognized complication of airway obstruction, particularly after endotracheal extubation. The application of oxygen therapy and continuous positive airway pressure with the administration of diuretics under a rapid diagnosis usually clears pulmonary edema. We report a case of 61-year-old man who developed negative pressure pulmonary edema following extubation after an endoscopic submucosal dissection under general anesthesia.

A Case of Pseudoaneurysm Developed during Intensive Treatment of Status Asthmaticus: A Case Report / 대한구급학회지

Pseudoaneurysm formation in the pulmonary vasculature is a rare but fatal condition. Several etiologies have been described including trauma, complication after cardiac or other surgeries, tuberculosis, necrotizing pneumonia, congestive heart disease, atherosclerosis, cancer and vasculitis. We report a case of pseudoaneurysm found in a patient being treated with status asthmaticus, who developed complications of pneumonia and brain abscess secondary to sepsis.