Multivessel spontaneous coronary artery dissection presenting as acute myocardial infarction

No abstract available.

Primary Signet Ring Cell Carcinoma of the Gallbladder Mimicking Calculous Cholecystitis / 대한췌담도학회지

Signet ring cell carcinoma is a rare form of gallbladder cancer and has a worse prognosis. Since few cases have been reported, information regarding the behavior and prognosis of the gallbladder carcinoma is limited. About twenty four cases of gallbladder signet ring cell carcinoma have been reported so far. We present a rare case of primary signet ring cell carcinoma of the gallbladder. A 58-year-old male presented with epigastric pain. Abdominal computed tomography showed diffuse gallbladder wall thickening with enhancement, gallstones, and choledocholithiasis. After endoscopic treatment of choledocholithiasis, laparoscopic cholecystectomy was performed. Pathologic examination of the resected gallbladder revealed adenocarcinoma of signet ring cell type in the epithelium. Immunohistochemical stain for cytokeratin 7 was positive for tumor cells. The final pathologic diagnosis was primary signet ring cell carcinoma of the gallbladder. Lymph node metastasis was detected and he received chemotherapy and radiotherapy. After one year of follow-up, bone metastasis in the lumbar spine and malignant ascites were found. The patient is being provided with palliative care.

Spontaneous Common Bile Duct Perforation Treated with Placement of Metal Stent / 대한췌담도학회지

Perforation of the biliary tree mostly results from injury to the bile duct during surgery or procedures such as endoscopic retrograde cholangiopancreatography (ERCP) and spontaneous bile duct perforation is rare in adults. As the clinical picture varies, early diagnosis and treatment of spontaneous biliary peritonitis is difficult. A 52-year-old male patient presented with abdominal pain and intractable ascites. He already experienced severe abdominal pain 2 months ago and underwent percutaneous pigtail drainage for the ascites at nearby hospital. ERCP showed large filling defect with leakage of contrast media from the mid common bile duct (CBD) into the peritoneal cavity. We performed endoscopic sphincterotomy and extracted CBD stones with basket and balloon catheter. Then fully covered self expandable metal stent was placed in CBD. After the procedure, the symptom was improved and the amount of pigtail drainage from abdominal cavity was dramatically decreased. 6 weeks later, removing the metal stent, there was no more leakage of contrast media into peritoneal cavity. We report a very rare case of spontaneous bile leakage which was successfully managed with placement of metal stent.

Spontaneous Common Bile Duct Perforation Treated with Placement of Metal Stent / 대한췌담도학회지

Perforation of the biliary tree mostly results from injury to the bile duct during surgery or procedures such as endoscopic retrograde cholangiopancreatography (ERCP) and spontaneous bile duct perforation is rare in adults. As the clinical picture varies, early diagnosis and treatment of spontaneous biliary peritonitis is difficult. A 52-year-old male patient presented with abdominal pain and intractable ascites. He already experienced severe abdominal pain 2 months ago and underwent percutaneous pigtail drainage for the ascites at nearby hospital. ERCP showed large filling defect with leakage of contrast media from the mid common bile duct (CBD) into the peritoneal cavity. We performed endoscopic sphincterotomy and extracted CBD stones with basket and balloon catheter. Then fully covered self expandable metal stent was placed in CBD. After the procedure, the symptom was improved and the amount of pigtail drainage from abdominal cavity was dramatically decreased. 6 weeks later, removing the metal stent, there was no more leakage of contrast media into peritoneal cavity. We report a very rare case of spontaneous bile leakage which was successfully managed with placement of metal stent.

Efficacy and Safety of Radiofrequency Ablation Performed by an Endocrinologist for Benign Thyroid Nodules

BACKGROUND AND OBJECTIVES: Radiofrequency ablation has recently been used for the treatment of benign thyroid nodules, with outstanding results. However, in most studies, the procedure was usually performed by a radiologist or surgeon. This study aimed to evaluate the efficacy and safety of radiofrequency ablation for nodules >2 cm performed by an endocrinologist with several years of experience performing fine-needle aspiration cytology. MATERIALS AND METHODS: This study was a cross-sectional analysis of 111 patients who received radiofrequency ablation between April 2010 and July 2013. A total of 73 patients with 75 nodules >2 cm in diameter with at least 6 months of follow-up examinations were included. RESULTS: The mean follow-up period was 11.5 months. The mean nodule volume decreased from 17.0+/-15.3 mL preoperatively to 6.0+/-8.5 mL postoperatively, with a mean volume reduction of 69.7%. There were no major complications, and only 1 patient (1.3%) presented with a minor complication (hemorrhaging of the thyroid parenchyma). CONCLUSION: Radiofrequency ablation is a safe method for reducing benign thyroid nodules, and is not associated with any major complications.

Single Nodular Pulmonary Amyloidosis: Case Report / 결핵및호흡기질환

Amyloidosis is defined as the presence of extra-cellular deposits of an insoluble fibrillar protein, amyloid. The pulmonary involvement of amyloidosis is usually classified as tracheobronchial, parenchymal nodular, or diffuse alveolar septal. A single nodular lesion can mimic various conditions, including malignancy, pulmonary tuberculosis, and fungal infection. To date, only one case of nodular pulmonary amyloidosis has been reported in Korea, a case involving multiple nodular lesions. Here, we report and discuss the case of a patient having single nodular amyloidosis.