Progressive Familial Heart Block Type I in a Korean Patient

A 29-year-old man was referred to the emergency department with a complaint of abdominal pain and dizziness. He had experienced two previous syncopal episodes. His family history revealed that his mother and his two uncles had received permanent pacemaker implantation. His initial heart rate was 49 beats per minute. The electrocardiography (ECG) showed atrial flutter and right bundle branch block (RBBB) with left anterior fascicular block (LAFB). On admission, 24-hour Holter showed ventricular pause up to 16 seconds during syncope. Radio frequency catheter ablation (RFCA) of atrial flutter was performed. The ECG revealed bifascicular block (RBBB and LAFB) and first-degree atrioventricular block. He received a permanent pacemaker implantation. His brother's and his sister's ECGs also showed trifascicular block and the pedigree showed autosomal dominant inheritance. This patient was diagnosed with a progressive familial heart block (PFHB) type I. This would be the first report of a PFHB type I case documented in Korea.

A Case of Meningeal Carcinomatosis from Prostate Cancer / 대한내과학회지

Meningeal carcinomatosis in patients with prostate cancer is very rare. Recently, we experienced a case of meningeal carcinomatosis in a patient with prostate cancer. He had undergone a radical prostatectomy 11 years before presentation and had undergone chemotherapy 4 years before presentation due to bone metastases. This time, he visited the emergency department because of a seizure. Although cerebrospinal fluid (CSF) examinations did not reveal malignant cells, we diagnosed meningeal carcinomatosis based on positive CSF prostate-specific antigen and magnetic resonance imaging (MRI) findings. The diagnosis was confirmed pathologically. We treated the patient with whole brain radiotherapy and intrathecal chemotherapy. We report a case of prostate cancer with meningeal carcinomatosis with a literature review.

Simultaneous Melanosis Duodeni and Melanosis Ilei in a Patient Taking Oral Iron / 대한소화기내시경학회지

Melanosis means the accumulation of brown or black pigment in an organ. Melanosis can be observed in virtually all parts of the gastrointestinal tract. However, it most frequently affects the colon. It is said that melanosis in small intestine is very rare, and no case has been reported in which melanosis was simultaneously noted in duodenum and ileum without involving the colonic mucosa. Here we report a case of melanosis duodeni and melanosis ilei which were found simultaneously in a 56-year-old female patient with chronic renal failure and heart failure who had been taking oral ferrous sulfate for 3 years.

Two Cases of Ischemic Colitis after Colonoscopy / 대한소화기내시경학회지

Ischemic colitis is the most common form of ischemia in the gastrointestinal tract. It results from inadequate blood flow in the colon that leads to inflammation of the colon. Though this disease frequently affects the elderly with risk factors of ischemia, younger patients may be affected too. Several conditions such as major vascular occlusion, small vessel disease, shock, some medications, colonic obstructions and hematologic disorders can predispose individuals to ischemic colitis. Ischemic colitis following colonoscopy is rare. Here we report 2 cases of ischemic colitis which developed after colonoscopic procedures in patients without risk factors of ischemia.

Left Atrial Mass with Stalk: Thrombus or Myxoma?

A 63-year-old female was presented to emergency room with an abdominal pain. The patient had moderate mitral valve stenosis and atrial fibrillation. Abdominal computed tomography revealed right renal infarction. Transthoracic echocardiography showed a large mobile mass in the left atrium. Transesophageal two-and three-dimensional echocardiography showed a large mobile ovoid mass with a narrow stalk attached to the left atrial septum. It was thought to be a myxoma rather than thrombus. Anticoagulation with heparin was continued. When the operation was performed, there was no mass in the left atrium. It must be a thrombus and melt away.