A Case of Primary Angiitis of the Central Nervous System: A Case Presentation

Primary angiitis of the central nervous system (PACNS) is a rare idiopathic disorder with recurrent vasculitis restricted to the central nervous system (CNS) and involves small-sized (and at time medium-sized) blood vessels. The typical clinical manifestations include multifocal strokes or encephalopathy, often associated with severe headaches. There are very few pediatric cases with PACNS reported in the literature. The diagnosis of PACNS is mainly based on its clinical features, demonstration of angiitis on angiography or biopsy, and exclusion of secondary causes of angiitis. A high index of suspicion is necessary for the diagnosis. Though the prognosis is generally poor, use of steroids and immunosuppressive therapy has been useful in achieving successful remission in many patients. We report the case of a patient with PACNS presenting recurrent headaches for 5 days.

A Case of Heterotopic Pancreas on the Fundus of Stomach by Gastrofiberscopy / 대한소화기내시경학회지

The Heterotopic pancreas is defined as the presence of pancreatic tissue lacking anatomical and vascular continuity with the main body of pancreas. Heterotopic pancreas or ectopic pancreas is found in 0.55% to 13.7% of autopsy series and also found one in approximately every 500 operations in abdominal surgery. The most common sites are the antrum of stomach, duodenum, and proximal jejunum. Most masses of heterotopic pancreas in stomach were encountered in the distal one third, usually within 5 or 6 cm of pylorus. We have recently experienced a case of hetertopic pancreas that was located in fundus which is not the usual site. Gastrofiberscopy revealed a 2 2.5 cm sized protruding mass on the fundus. There was apperared an umbilical shaped dimple on the center with a relatively normal mucosa. Endoscopic ultrasonography revealed a 2.5 cm sized hypoechoic mass of fundus, originating from submucosal and muscular layer. It was considered a submucosal tumor, such as leiomyoma, and subsequently wedge resection was performed. Histologic finding showed pancreatic acni.

Two Cases of Pulmonary Complications Following Intravesical Bacillus Calmette-Guerin Immunotherapy in Patients with Superficial Bladder Cancer / 결핵

Intravesical instillation of the bacillus Calmentte-Gu rin(BCG), an attenuated strain of Mycobacterium bovis, is an approved method for the treatment of superficial bladder cancer. Because BCG is a living organism, the potential for infection exists. BCG is generally well tolerated, with complications in less than 5% of those treated with use of current practices. The most frequent symptoms of toxicity associated with intravesical BCG immunotherapy include bladder irritation, frequency, and dysuria. Systemic reactions are less common but more serious than local side effects, and include fever, chills, malaise, rash, hepatitis, pneumonitis, arthritis and sepsis. In rare cases, BCG treatment can result in a systemic infection that requires antituberculous therapy. The pulmonary toxicity that results from intravesical BCG treatment is generally characterized by one of two types : systemic allergic reaction with pulmonary reticulonodular opacities depicted on chest radiographs with cellular findings consisting of activated lymphocytes, and actual BCG mycobacteremia with a miliary pattern depicted on chest radiographs and granuloma formation which rarely results in positive acid-fast stain or culture results. Recently we experienced two types of pulmonary complications following intravesical BCG immunotherapy in patients with superficial bladder cancer. We report two cases with a review of literatures.

A Case of Congenital Renal Arteriovenous Malformation with Severe Gross Hematuria / 대한신장학회잡지

Congenital renal arteriovenous malformation is a rare disease. Renal arteriovenous malformations have been discovered with increasing frequency since they were first described by Varela in 1923. Patients with arteriovenous malformations may have gross hematuria, flank pain, urinary obstruction or may be asymptomatic. The diagnosis of arteriovenous malformation is usually made by renal angiogram. Treatment of arteriovenous malformation can be obtained with conservative treatment, ligation of the arterial branch, selective transcatheter embolization and surgical procedures. We experienced a case of congenital arteriovenous malformation manifested by gross hematuria and intermittent right flank pain, cured by means of transcatheter arterial embolization therapy with gelfoam and alcohol. Thus, we report a case with a brief review of literatures.