1.Multiple Pulmonary Nodules in A Patient with Sinusitis, Proteinuria and Hematuria.
Su Eun YU ; Kang JOO ; Chee Ho NOH ; So Hyang SONG ; Chi Hong KIM ; Yong Jin PARK ; Seok Jin KANG
Tuberculosis and Respiratory Diseases 2002;53(4):463-469
A 49-year old man who had been treated for five months at a private clinic due to chronic paranasal sinusitis was admitted to our hospital because of recently aggravated nasal stuffiness, headache, and cough. The X-ray film of paranasal sinuses and facial CT scan showed marked mucosal thickening of the nasal cavity and paranasal sinuses. The plain chest film and chest CT scan showed multiple, variable sized, pulmonary nodules in both lungs. The level of c-ANCA was elevated and urinalysis revealed proteinuria and hematuria. Percutaneous lung and kidney biopsies were performed for confirmative diagnosis. Histologic examination of the lung nodule demonstrated extensive necrosis and poorly-formed granulomatous inflammation. The histologic finding of the kidney showed focal necrotizing glomerulonephritis. A diagnosis of Wegener's granulomatosis involving the paranasal sinuses, lung and kidney was made, and treatment was successfully performed with cyclophosphamide and prednisone.
Antibodies, Antineutrophil Cytoplasmic
;
Biopsy
;
Cough
;
Cyclophosphamide
;
Diagnosis
;
Glomerulonephritis
;
Headache
;
Hematuria*
;
Humans
;
Inflammation
;
Kidney
;
Lung
;
Middle Aged
;
Multiple Pulmonary Nodules*
;
Nasal Cavity
;
Necrosis
;
Paranasal Sinuses
;
Prednisone
;
Proteinuria*
;
Sinusitis*
;
Thorax
;
Tomography, X-Ray Computed
;
Urinalysis
;
Wegener Granulomatosis
;
X-Ray Film
2.A case of colonic and omental lipomatosis and omental torsion presenting with abdominal pain.
Se Min LEE ; Dae Young CHEUNG ; Myoung Beom KOH ; Chee Ho NOH ; Seong Yong WOO ; Jin Il KIM ; Jae Kwang KIM
Korean Journal of Medicine 2009;76(4):485-489
A lipoma, one of the most commonly encountered submucosal tumors in the gastrointestinal tract, usually presents as one or a few lesions. Lipomatous polyposis, which is defined as the presence of multiple lipomas in the intestinal wall, is rare. Here, we report a case of colonic lipomatous polyposis that involved not only the colon, but also the omentum and skeletal muscle. The patient presented with right lower quadrant abdominal pain and was diagnosed using colonoscopy and computed tomography (CT). The abdominal pain caused by omental torsion due to an omental lipoma resolved after conservative treatment without surgical intervention.
Abdominal Pain
;
Colon
;
Colonoscopy
;
Gastrointestinal Tract
;
Humans
;
Lipoma
;
Lipomatosis
;
Muscle, Skeletal
;
Omentum
3.Gastric Inflammatory Fibroid Polyp Resected by Endoscopic Submucosal Dissection.
Hyeon Seong KIM ; Jin Il KIM ; Myoung Beom KOH ; Chee Ho NOH ; Se Min LEE ; Dae Young CHEUNG ; Soo Heon PARK ; Jae Kwang KIM
Korean Journal of Gastrointestinal Endoscopy 2009;38(4):224-228
Inflammatory fibroid polyp (IFP) is a rare benign fibroproliferative disease that arises from the submucosal layer of the gastrointestinal tract. Surgical resection has been performed in most cases and the application of endoscopic resection is rare. Endoscopic submucosal dissection (ESD), which was recently introduced, enables en-bloc resection of a tumor regardless of the tumor size and location. Since IFP is benign, ESD can be very useful for both the diagnosis and treatment of a large-sized IFP. A 45-year-old woman was referred for the management of a gastric mass. Esophagogastroduodenoscopy showed a round submucosal mass with a central bulging at the gastric body. Endoscopic ultrasonography showed a 3.5x3.0 cm-sized hypoechoic mass in the third layer of the stomach. The tumor was removed by ESD with using a hook knife for complete en-bloc resection. The pathologic finding was compatible with the diagnosis of IFP. We report here on a case of IFP that presented as a gastric submucosal tumor and it was treated by the ESD method.
Endoscopy, Digestive System
;
Endosonography
;
Female
;
Gastrointestinal Tract
;
Humans
;
Leiomyoma
;
Middle Aged
;
Polyps
;
Stomach
4.Primary Hyperaldosteronism with Increased Plasma Renin Activity due to Secondary Hypertensive Renal Impairment.
Kang Woo LEE ; Hyuk Sang KWON ; Dong Il SHIN ; Chee Ho NOH ; Jung Min LEE ; Jong Min LEE ; Kun Ho YOON ; Bong Yun CHA ; Kwang Woo LEE ; Ho Young SON ; Sung Koo KANG
Journal of Korean Society of Endocrinology 2003;18(4):433-438
An increased plasma aldosterone concentration, with suppressed plasma renin activity (PRA), is an abnormal finding in primary hyperaldosteronism. A suppressed PRA is caused by aldosterone- dependent sodium retention and extracellular volume expansion. A case of primary hyperaldosteronism, due to adenoma, with increased PRA, was observed. An adrenalectomy and intraoperative renal biopsy was performed. In our patient, histologically proven renal arteriosclerosis was the probable cause of the escape of the PRA from the suppression by an aldosterone-producing adenoma. Normal blood pressure was not attained after the adrenalectomy. However, the blood pressure was then controlled by small doses of antihypertensive drug before resection of the tumor. In this case, the patient was treated with spironolactone, but the blood pressure was not correctly controlled. After the adrenalectomy, the blood pressure was well controlled with smaller dose of calcium channel blockers. So, an early adrenalectomy may be beneficial as soon as the diagnosis of an aldosterone-producing adenoma is confirmed, even in patients with hypertensive nephrosclerosis.
Adenoma
;
Adrenalectomy
;
Aldosterone
;
Arteriosclerosis
;
Biopsy
;
Blood Pressure
;
Calcium Channel Blockers
;
Diagnosis
;
Humans
;
Hyperaldosteronism*
;
Nephrosclerosis
;
Plasma*
;
Renin*
;
Sodium
;
Spironolactone
;
United Nations
5.Remission of Ulcerative Colitis after Appendectomy: A Case Report.
Chee Ho NOH ; Dae Young CHEUNG ; Tae Ho KIM ; Eun Jung JUN ; In Kyu LEE ; Jin Il KIM ; Se Hyun CHO ; Soo Heon PARK ; Joon Yeol HAN ; Jae Kwang KIM
The Korean Journal of Gastroenterology 2010;56(3):201-204
The inverse correlation of appendectomy and ulcerative colitis is well known, but the effect of appendectomy on the clinical course of ulcerative colitis remains unclear. Although the majority of opinions were negative for the therapeutic advantage of appendectomy in patients with ulcerative colitis, advocates for positive effect of appendectomy have been proposed in a few case reports and a prospective study from Western countries. We herein report a case of ulcerative colitis who experienced clinical remission after appendectomy for acute appendicitis. The patient was 35 year old male and had been managed with immunosuppressant before appendectomy. The very acute change in clinical course and a long period of remission after appendectomy highly suggest the therapeutic effect of appendectomy for ulcerative colitis.
6-Mercaptopurine/therapeutic use
;
Adult
;
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
;
*Appendectomy
;
Colitis, Ulcerative/*diagnosis/drug therapy/surgery
;
Colonoscopy
;
Humans
;
Immunosuppressive Agents/therapeutic use
;
Male
;
Mesalamine/therapeutic use
;
Tomography, X-Ray Computed
;
Treatment Outcome
6.A Case of Stricture of Second Portion of Duodemum Induced by Chronic Use of Nonsteroidal Anti-inflammatory Drug in Patient with Ankylosing Spondylitis and Rheumathoid Arthritis: A case report.
Jeong Seon JI ; Hyun Wha CHUNG ; Dong Jun LIM ; Chang Nyol PAIK ; Chee Ho NOH ; Soo Heon PARK ; Do June MIN ; Jin Il KIM ; Joon Yul HAN ; Jae Kwang KIM ; Gyu Yong CHOI ; In Sik CHUNG ; Kyu Won CHUNG ; Hee Sik SUN
Korean Journal of Gastrointestinal Endoscopy 2001;23(2):109-112
In endoscopic clinical research studies of patients who take NSAIDs, 10% to 20% of patients develop gastric ulcers and 4% to 10% develop duodenal ulcers. Ulcers associated with chronic NSAIDs use are typically painless and are located in the prepyloric region of the stomach. These characteristics make NSAIDs potential causes of gastric outlet obstruction. There were multiple cases of single or multiple strictures that were found in the esophagus, small bowel and colon. Most of duodenal strictures were confined to bulbar area. Only one case of duodenal second portion diaphragmlike stricture was reported in association with acetylsalicylic acid. We experienced one case of chronic NSAIDs induced duodenal 2nd portion stricture in ankylosing spondylitis and rhemathoid arthritis patient and reported with a review of literature.
Anti-Inflammatory Agents, Non-Steroidal
;
Arthritis*
;
Aspirin
;
Colon
;
Constriction, Pathologic*
;
Duodenal Ulcer
;
Esophagus
;
Gastric Outlet Obstruction
;
Humans
;
Spondylitis, Ankylosing*
;
Stomach
;
Stomach Ulcer
;
Ulcer
7.Change in the serologic markers of hepatitis B after allogenic hematopoietic stem-cell transplantation.
Seong Yong WOO ; Se Hyun CHO ; Se Min LEE ; Myoung Beom KOH ; Chee Ho NOH ; Chang Wook KIM ; Jong Young CHOI ; Jin Mo YANG ; Joon Yeol HAN ; Young Sok LEE
The Korean Journal of Hepatology 2009;15(2):131-139
BACKGROUND/AIMS: This study examined the effects of hepatitis B virus (HBV) infection state and immunologic capability in both the recipients and donors of allogenic hematopoietic stem-cell transplantation (allo-HSCT) on changes in HBV serologic markers in recipients. METHODS: A total of 537 patients underwent allo-HSCT for the treatment of leukemia, malignant lymphoma, and solid tumor. HBV serologic markers were examined in both recipients and donors prior to and following the transplantation. The mean follow-up period was 36.6 months (range 3-80 months). RESULTS: Of the 537 patients who underwent allo-HSCT, 45 recipients were positive for HBsAg prior to transplantation. Of these 45 patients, 21 were transplanted from anti-HBs-positive donors and the remaining 24 were transplanted from anti-HBs-negative donors. In the former cases, seroconversion was noted in 4 of the 21 patients (19%). In the latter cases, however, no seroconversion was noted following the transplantation. Thirty patients who were negative for both HBsAg and anti-HBs were transplanted from anti-HBs-positive donors, and 15 out of 30 patients (50%) acquired anti-HBs. Four hundred and seven patients who were positive for anti-HBs were transplanted from anti-HBs-positive or HbsAg-negative donors; 8 of these proved HBsAg-positive following the transplantation. There were no changes in HBV serological markers following transplantation in 41 patients who were transplanted from HbsAg-positive donors. CONCLUSIONS: Due to the adoptive immunity that was transferred from anti-HBs-positive donors, a seroconversion of HBsAg could occur in some HBsAg-positive recipients. HBsAg-positive donors had a lesser effect on the HBV serologic markers of recipients. However, a reactivation of HBV can occur following hematopoietic stem-cell transplantation in the cases of recipients or donors with a history of HBV, infection by an accompanying immune suppression. Therefore, prevention should be instigated.
Adolescent
;
Adult
;
Aged
;
Biological Markers/blood
;
Female
;
*Hematopoietic Stem Cell Transplantation
;
Hepatitis B/diagnosis/*immunology
;
Hepatitis B Antibodies/blood
;
Hepatitis B Surface Antigens/blood
;
Humans
;
Male
;
Middle Aged
;
Retrospective Studies
;
Tissue Donors
;
Transplantation, Homologous
;
Virus Activation
8.Congenital Hemidiaphragmatic Agenesis Presenting as Reversible Mesenteroaxial Gastric Volvulus and Diaphragmatic Hernia: A Case Report.
Hye Young SUNG ; Se Hyun CHO ; Sung Bo SIM ; Jin Il KIM ; Dae Young CHEUNG ; Soo Heon PARK ; Joon Yeol HAN ; Se Min LEE ; Chee Ho NOH ; Yong Bum PARK ; Seung Eun JUNG ; Seon Hui LEE ; Kyu Yong CHOI
Journal of Korean Medical Science 2009;24(3):517-519
A 70-yr-old woman complained of left sided chest pain and non-bilious vomiting for four days after taking a gastric bloating agent for an upper gastrointestinal study. The chest radiography revealed gastric air-fluid levels and bowel loops in the left thoracic cavity. An emergency thoracotomy was performed. The abdominal organs (stomach, spleen, splenic flexure of the colon) were in the left thorax and the entire left hemidiaphragm was absent. There were no diaphragmatic remnants visible for reconstruction of the left diaphragm. We provided warm saline irrigation and performed a left lower lobe adhesiotomy. Thirteen days after surgery, the chest radiography showed improvement in the herniation but mild haziness remained at the left lower lung field. Here we present the oldest case of congenital diaphragmatic agenesis presenting with transient gastric volvulus and diaphragmatic hernia.
Aged
;
Diagnosis, Differential
;
Diaphragm/*abnormalities/radiography/surgery
;
Female
;
Hernia, Diaphragmatic/*diagnosis/radiography/surgery
;
Humans
;
Stomach Volvulus/*diagnosis/surgery
;
Tomography, X-Ray Computed
9.Congenital Hemidiaphragmatic Agenesis Presenting as Reversible Mesenteroaxial Gastric Volvulus and Diaphragmatic Hernia: A Case Report.
Hye Young SUNG ; Se Hyun CHO ; Sung Bo SIM ; Jin Il KIM ; Dae Young CHEUNG ; Soo Heon PARK ; Joon Yeol HAN ; Se Min LEE ; Chee Ho NOH ; Yong Bum PARK ; Seung Eun JUNG ; Seon Hui LEE ; Kyu Yong CHOI
Journal of Korean Medical Science 2009;24(3):517-519
A 70-yr-old woman complained of left sided chest pain and non-bilious vomiting for four days after taking a gastric bloating agent for an upper gastrointestinal study. The chest radiography revealed gastric air-fluid levels and bowel loops in the left thoracic cavity. An emergency thoracotomy was performed. The abdominal organs (stomach, spleen, splenic flexure of the colon) were in the left thorax and the entire left hemidiaphragm was absent. There were no diaphragmatic remnants visible for reconstruction of the left diaphragm. We provided warm saline irrigation and performed a left lower lobe adhesiotomy. Thirteen days after surgery, the chest radiography showed improvement in the herniation but mild haziness remained at the left lower lung field. Here we present the oldest case of congenital diaphragmatic agenesis presenting with transient gastric volvulus and diaphragmatic hernia.
Aged
;
Diagnosis, Differential
;
Diaphragm/*abnormalities/radiography/surgery
;
Female
;
Hernia, Diaphragmatic/*diagnosis/radiography/surgery
;
Humans
;
Stomach Volvulus/*diagnosis/surgery
;
Tomography, X-Ray Computed
10.A Case of Gastrointestinal Bleeding Caused by Dieulafoy-like Lesions of the Stomach and Rectum in a Patient with Chronic Renal Failure.
Chul Hyun LIM ; Young Seok CHO ; Hyun Jin KIM ; Sung Jin MOON ; Seung Woo LEE ; Chee Ho NOH ; Dong Il SHIN ; Jong Hyun PARK ; Chang Whan KIM ; Sung Soo KIM ; Young Ok KIM ; Sun Ae YOON ; Hiun Suk CHAE ; Chang Don LEE ; Kyu Yong CHOI ; In Sik CHUNG
Korean Journal of Gastrointestinal Endoscopy 2004;28(3):146-150
Dieulafoy's lesion is a very rare cause of gastrointestinal bleeding that occurs after rupture of an exposed submucosal artery. The majority of lesions are found in the stomach, but rarely it has also been identified in the duodenum, small bowel, colon and rectum. We describe a 78-year-old female with chronic renal failure who presented with melena and was subsequently found to have a Dieufaloy-like lesion in the stomach. The bleeding was successfully managed by endoscopic hemoclipping. During the follow-up, massive gastrointestinal bleeding was developed by a Dieulafoy-like lesion in the rectum. This lesion was managed by endoscopic band ligation, but there was recurrent bleeding from the ulcer site. The ulcer site was locally excised and primary closure was carried out.
Aged
;
Arteries
;
Colon
;
Duodenum
;
Female
;
Follow-Up Studies
;
Hemorrhage*
;
Humans
;
Kidney Failure, Chronic*
;
Ligation
;
Melena
;
Rectum*
;
Rupture
;
Stomach*
;
Ulcer