Clinical Effectiveness of Percutaneous Angioplasty for Acute and Chronic Mesenteric Ischemia: A Six Case Series / 대한소화기학회지

Intestinal ischemia is divided into three categories, namely, acute mesenteric ischemia (AMI), chronic mesenteric ischemia (CMI), and colonic ischemia. AMI can result from arterial or venous thrombi, emboli, and vasoconstriction secondary to low-flow states. It is an urgent condition which can result in high mortality rate. The predominant causative factor of CMI is stenosis or occlusion of the mesenteric arterial circulation, and it is characterized by postprandial abdominal pain and weight loss. Surgery is the treatment of choice for intestinal ischemia. However, it has been recently reported that percutaneous transluminal angioplasty with stent placement and/or thrombolysis is an effective therapy in various types of mesenteric ischemia. We report six cases of mesenteric ischemia which were successfully treated by percutaneous angioplasty, and review the literature from South Korea.

Clinical Effectiveness of Percutaneous Angioplasty for Acute and Chronic Mesenteric Ischemia: A Six Case Series / 대한소화기학회지

Intestinal ischemia is divided into three categories, namely, acute mesenteric ischemia (AMI), chronic mesenteric ischemia (CMI), and colonic ischemia. AMI can result from arterial or venous thrombi, emboli, and vasoconstriction secondary to low-flow states. It is an urgent condition which can result in high mortality rate. The predominant causative factor of CMI is stenosis or occlusion of the mesenteric arterial circulation, and it is characterized by postprandial abdominal pain and weight loss. Surgery is the treatment of choice for intestinal ischemia. However, it has been recently reported that percutaneous transluminal angioplasty with stent placement and/or thrombolysis is an effective therapy in various types of mesenteric ischemia. We report six cases of mesenteric ischemia which were successfully treated by percutaneous angioplasty, and review the literature from South Korea.

A Case of Idiopathic Sclerosing Mesenteritis with Retroperitoneal Fibrosis / 대한소화기학회지

Sclerosing mesenteritis is a rare inflammatory disease of the bowel mesentery. It produces tumor-like masses of the mesentery composed of varying degrees of fibrosis, chronic inflammation, and fat necrosis. It has been described variously as fibrosing mesenteritis, retractile mesenteritis, mesenteric Weber Christian disease, and systemic nodular panniculitis. The etiology and pathogenesis of the disease are as yet unknown, but autoimmune disorder, previous abdominal surgery, trauma, and ischemia could play a role. The clinical features include abdominal pain, vomiting, diarrhea, and constipation. Occasionally, patients with this condition may present with bowel obstruction. Rarely, It can be associated with other idiopathic inflammatory disorders such as retroperitoneal fibrosis, sclerosing cholangitis, and orbital pseudotumors. We report a case of idiopathic sclerosing mesenteritis with retroperitoneal fibrosis in a 58-year-old man.

A Case of Exceptionally Rapid Growing Cardiac Myxoma / 영남의대학술지

Myxoma is the most common type of primary cardiac tumor and about 75% of myxomas occur in the left atrium of the heart. Most myxomas are diagnosed by echocardiography. The growth rate of myxoma is clearly unknown and newly developed myxoma is difficult to understand clearly the onset of growth. We describe the case of a newly developed huge left atrial myxoma (7x7 cm)which showed no echocardiographic evidence of the tumor four years ago. Four years later the patient underwent transthoracic echocardiography due to preoperative evaluation that was normal. Nine months later, she presented with dyspnea. Transthoracic echocardiography showed a large mass located in left atrium. Pathology showed a myxoma that measured 7x7 cm implying a growth rate of 0.15x0.15 cm/month.

Incidence of tuberculosis in Korean diabetics: Comparison with that in non-diabetic hypertensive subjects / 대한내과학회지

BACKGROUND/AIMS: Tuberculosis remains a major cause of mortality in South Korea, and the prevalence of diabetes is also increasing rapidly. Diabetes is a well known risk factor for tuberculosis. However, the risk varies according to race and regional prevalence. We assessed the potential impact of diabetes as a risk factor for tuberculosis in South Korea. METHODS: We performed a retrospective cohort study in a secondary referral hospital. The incidence of tuberculosis in a diabetic cohort was compared with that in a non-diabetic hypertensive cohort for 6 years. Diabetics who visited our diabetic clinic and non-diabetic hypertensive patients who visited our cardiology clinic from Jan 2004 to April 2004 were assigned to the diabetic cohort and the non-diabetic hypertensive cohort, respectively. Patients in each cohort had to receive medications to control their diseases. Patients with end-stage renal disease, malignancy, or HIV infection were excluded. Relative risk and tuberculosis-free survival rates of each cohort were calculated. RESULTS: The incidences of tuberculosis were 32 in the diabetic cohort (n=2491; mean age, 59.1+/-11.8 years; 44.5% male) and ten in the non-diabetic hypertensive cohort (n=1885; mean age, 59.9+/-12.8 years; 41.6% male). The estimated annual incidences per 100,000 persons were 282.8 and 112.9, respectively. The relative risk was 2.220 (p=0.028; 95% confidence interval, 1.090~4.523). However, no significant difference in cumulative tuberculosis-free survival rate was observed between the cohorts (p=0.075). CONCLUSIONS: A trend for a higher incidence of tuberculosis existed in diabetics, as compared to non-diabetic hypertensive patients, among a Korean population.

A Case of Pseudochylothorax Developed from Chronic Pleural Effusion after Treatment of Tuberculous Pleurisy / 결핵및호흡기질환

A pseudochylothorax, a chyliform pleural effusion, is a rare disease of pleural effusion that contains cholesterol crystals or high lipid content that is not the result of a disrupted thoracic duct. Most of the cases were found in patients with long-standing pleural effusion due to chronic inflammatory disease, such as old tuberculous pleurisy or chronic rheumatoid pleurisy. We experienced a case of pseudochylothorax in a 74-year-old man, who was being treated for pulmonary tuberculosis and pleurisy 10 years ago. The diagnosis was confirmed on pathological study of the pleural effusion, which contained cholesterol crystals having a diagnostic rhomboid appearance.