The Hidden Culprit: A Case of Repeated Anaphylaxis to Cremophor

Drug-induced anaphylaxis is a big pitfall in patients receiving antineoplastic chemotherapy. We report a case of lung cancer patient who experienced two near-fatal anaphylactic reactions that resulted from paclitaxel and multivitamin, seperately. Recurrent severe reactions to different agents led to further investigation to which material the patient was hypersensitive. The skin prick test revealed sensitization to cremophor, which is a commonly used emulsifying agent. This case emphasizes the importance of correctly identifying the culprit drug of anaphylaxis to avoid potentially fatal reaction.

Paroxysmal Nocturnal Hemoglobinuria Presenting as Recurrent Jejunitis / 대한내과학회지

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired hematopoietic stem cell disorder characterized by chronic complement-mediated intravascular hemolysis, nocturnal hemoglobinuria, predisposition to thrombosis and secondary bone marrow failure. Small bowel ischemia is a complication of PNH but has not been reported to date in a Korean adult. We report here a case of PNH presenting as recurrent jejunitis. Despite the uncommon etiology, PNH should be considered in the differential diagnosis of patients with unexplained recurrent jejunitis.

Simultaneous Multivessel Acute Stent Thrombosis in a Patient with Gastrointestinal Bleeding / 대한내과학회지

Stent thrombosis is a rare, but potentially catastrophic complication of stent implantation. Dual antiplatelet therapy with aspirin and a thienopyridine (clopidogrel, prasugrel, or ticagrelor) is essential to minimize the risk of stent thrombosis in patients receiving drug-eluting stents. However, there is an ongoing debate regarding antiplatelet therapy in patients presenting with acute coronary syndrome and bleeding. Here, we report a case of a 59-year-old man with acute stent thrombosis immediately after percutaneous coronary intervention combined with acute coronary syndrome and gastrointestinal bleeding.

Isolated Endobronchial Mycobacterium avium Disease Associated with Lobar Atelectasis in an Immunocompetent Young Adult: A Case Report and Literature Review / 결핵및호흡기질환

The prevalence of lung diseases caused by nontuberculous mycobacteria (NTM) is increasing worldwide. Unlike pulmonary tuberculosis, endobronchial NTM diseases are very rare with the majority of cases reported in patients with human immunodeficiency virus infection and acquired immune deficiency syndrome. We reported a rare case of endobronchial Mycobacterium avium disease associated with lobar atelectasis in a young immunocompetent patient and reviewed the relevant iterature.

The Influence of Segmental Pedicle Screw Fixation on Distal Fusion Level in KingType I Adolescent Idiopathic Scoliosis(AIS) / 대한척추외과학회지

STUDY DESIGN: This study analyzes the influence of segmental pedicle screw fixation on distal fusion extent of King type I adolescent Idiopathic scoliosis(AIS). OBJECTIVES: To verify the efficacy of segmental pedicle screw fixation in preservation of distal lumbar motion segments. SUMMARY OF BACKGROUND DATA: King type I AIS has usually been treated by fusion to L4. However, segmental pedicle screw fixation may shorten the distal fusion extent by reducing the hopi-Bontal tiIt of the lower end vertebra. MATERIALS AND METHODS: Eighteen King type I AIS subjected to segmental pedicle screw fixation of both curves were analyzed after a minimum follow-up of 2 years. Fourteen were fused to L3(short fusion group, SF) and 4 were fused to L4(long fusion group, LF). They were compared for correction of deformity, spinal balance and L4 tiIt. RESULTS: In SF group, the thoracic currie showed 71.6% correction. Lumbar curve and L4 tiIt corrections were 76.8% and 75.2% respectiveIY. In LF group, the thoracic currie showed 65.2% correction. Lumbar currie and L4 tilt corrections were 76.8% and 78.4% respectively. There was no significant difference between two groups. Spinal balance was maintained in all patients(SF 14/14; LF 4/4). CONCLUSIONS: Segmental pedicle screw fixation may shorten the distal fusion extent of King type IAIS to L3, preserving a distal motion segment with a correction of deformity and spinal balance comparable to fusion down to L4. It is attributed to enhanced segmental control of the system enabling horizontalization of L4.