A First Case of Osteomesopyknosis in Korea.

Osteomesopyknosis is a rare sclerosing bone disorder of autosomal dominant inheritance. We report a first case of osteomesopyknosis in Korea. A 16-year old girl complained of diffuse back pain for 1 year. We performed physical examination, biochemical investigations and imaging studies. A radiograph of spine revealed rugger-jersey vertebra and sandwich vertebra. Bone specific alkaline phosphatase, osteocalcin and C-terminal telopeptides of type I collagen were normal. Only an axial skeleton involvement was shown on the whole body bone scan. This patient was diagnosed to have osteomesopyknosis. Osteomesopyknosis is characterized by normal level of bone turnover marker and an axial bone involvement. Osteomesopyknosis can be occurred in Korea and needs to be considered when patients, especially young patients, suffer from back pain and have only axial osteosclerosis.

Esophageal cancer treated by endoscopic submucosal dissection after neoadjuvant chemoradiotherapy: a case report.

INTRODUCTION: The treatment of esophageal cancer remains clinically challenging because of the overall poor prognosis associated with the disease. The mortality rate associated with surgical treatment is high, and the majority of diagnosed patients are old. As such, surgery is not possible in many cases, even when the cancer has progressed to a resectable state. CASE PRESENTATION: We present the case of an 82-year-old Korean man who presented to our institution with intermittent odynophagia. Esophageal cancer with submucosal invasion and metastasis to three regional lymph nodes was diagnosed. After neoadjuvant chemoradiotherapy, his regional lymph nodes disappeared. Because of his poor pulmonary function, surgical treatment could not be performed. Endoscopic submucosal dissection was carried out instead, and endoscopic triamcinolone injections were performed serially. Neither recurrence nor abnormal symptoms such as dysphagia or regurgitation have developed for 36 months. CONCLUSIONS: The literature suggests that endoscopic submucosal dissection after chemoradiotherapy is a viable treatment modality in patients with esophageal cancer with a high surgical treatment risk.

Pancreatic pseudocystocolonic fistula treated without surgical or endoscopic intervention.

We report here a case of pancreatic pseudocystocolic fistula that was treated without surgical or endoscopic intervention. A 76-year-old woman, presenting with a fever and epigastric pain, was referred to our institution. Three months prior to this admission, the patient had been admitted to the hospital for acute pancreatitis. Abdominal computerized tomography (CT) revealed a 9 cm pseudocyst containing air, and a fistular opening was observed via colonoscopy. After colonoscopy, the abdominal pain was slightly improved, the fever subsided and laboratory results showed decreased C-reactive protein levels. The observed improvement was likely due to the cleansing of the bowel, which induced spontaneous drainage from the pseudocyst into the colon. Antibiotic therapy was administered and daily bowel cleansing was performed using a polyethylene glycol solution. After three weeks, a follow-up CT revealed that the size of the pseudocyst had decreased significantly from 9 to 5.3 cm. In addition, laboratory tests were improved. The patient was able to resume a normal diet and was discharged in good overall health from the hospital, without aggravation of the symptoms. A colonoscopy performed 3 mo later and a follow-up CT performed 6 mo later confirmed that both the fistula and pseudocyst had completely disappeared.