The Brunner's gland adenoma is characterized by a nodular proliferation of histologically normal Brunner's gland, accompanied by ducts and scattered stromal elements. First descrived by Salvioli in 1876, the tumor is relatively rare, with 119 cases reported by 1977, The most common benign tumor of the small bowel is the adenoma, 25% of which occur in the duodenum. They make up 30% to 50% of all hyperplastic polyps of the duodenum. Most frequently these tumors are discovered in patients in the fourth to sixed decades of life, though the age in reported caes ranges from l 1 days to 80 years. The benign tumors of the duodenum 30% to 50% contain elements of Brunner's gland and 10.6% of them are adenomas of Brunner's gland. We report a case of Brunner's gland adenoma treated by endoscopic polypectomy in 63 year-old woman, and reviewed the literatues of adenoma of the Brunne'r gland.
Adenoma* ; Duodenum ; Female ; Gastrointestinal Hemorrhage ; Humans ; Middle Aged ; Polyps

Esophagea1 achalasia is a disease of unkown etiology characterized by abscenee of peristalsis in the body of the esophagus and failure of the lower esaphageal sphincter to relax in response to swallow. The cause has been suggested by the lack or abscence of ganglion cell in Auerbach's plexus. About 10% of patients with achalasis develop pulmonary complication such as aspiration pnuemonia, pulmonary fibrosis, pulmonary tuberculosis, culosis, bronchiectasis, lung abscess and bronchial asthma. Although aspiration pneumonia is the most common pulmonary complication in patients with achalasia, lung abscess is the extremely rare complication. A 48 years old female, who has experienced dysphagia and regurgitation for several years, is hospitalized because of high fever, cough and sputurn for 2 weeks. Lung abscess in apicoposterior segment of left upper lobe is observed in X-ray and chest CT. The findings of esophagogram, esophagogastroscopy and esophageal manometry are consistent with achalasia. We report a case of lung abscess associated with achalasia.
Asthma ; Bronchiectasis ; Cough ; Deglutition Disorders ; Esophageal Achalasia* ; Esophagus ; Female ; Fever ; Ganglion Cysts ; Humans ; Lung Abscess* ; Lung* ; Manometry ; Middle Aged ; Myenteric Plexus ; Peristalsis ; Pneumonia, Aspiration ; Pulmonary Fibrosis ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary

Nocardiosis is a rare infection seen most commonly in immunocompromized patients. Most patients have pulmonary involvement, but some develop disseminated infection. A 52-year-old man, treated with immunosuppressive drugs for 3 months after kidney transplantation, developed pulmonary nocardiosis and disseminated infection involving brain, skin, and both uvea. The diagnosis was made by open lung biopsy specimens showing characteristic weak acid fastness with modified Ziel-Neelsen stainig and histologic examination. Immunosuppressive therapy was continued and combination of surgical drainage of brain abscess and chemotherapy with Minocycline were successful. With the increasing number of allograft recipients and concomitant immunosuppression, the possibility of an increase in Nocardia opportunistic infections exists.
Allografts ; Biopsy ; Brain ; Brain Abscess ; Diagnosis ; Drainage ; Drug Therapy ; Humans ; Immunosuppression ; Kidney Transplantation ; Kidney* ; Lung ; Middle Aged ; Minocycline ; Nocardia ; Nocardia Infections* ; Opportunistic Infections ; Skin ; Transplantation* ; Uvea

Strongyloides stercoralis is distinguished by a capacity, unusual among helminths to replicate within the human host, thereby permitting on going cycle of autoinfection due to internal production of internal larvae. It has a worldwide distribution but is much more common in tropical climates where the warm, moist soil offers an environment suited to the development of the larvae. In immunocompromised hosts who receiving corticosteroids, immunosupressive drugs, or radiotherapy in these with AIDS, large numbers of invasive strongyloides larvae can disseminate widely and be fatal. The presents case is a 76 year-old-woman presenting with vomiting and epigastric pain. The patient had a long history of adminstration of steroid and alcohol. A gastrofibroscopic biopsy and stool examination revealed rhabditoid larvae. The patient seems to have suffered from autoinfection with S. stercoralis. We report this case with the review of literatures.
Adrenal Cortex Hormones ; Alcoholics* ; Biopsy ; Helminths ; Humans ; Immunocompromised Host ; Larva ; Liver Diseases, Alcoholic* ; Radiotherapy ; Soil ; Strongyloides stercoralis* ; Strongyloides* ; Tropical Climate ; Vomiting

Enteropathy-associated T-cell lymphoma (EATL) is an unusual primary gastrointestinal lymphoma, particularly associated with celiac sprue. This tumor usually affects the jejunum and grossly presents as multiple circumferential ulcers without the formation of definite tumor masses. Moreover, mesenteric lymph nodes are commonly involved. The patients have typically suffered from abdominal pain, diarrhea, or weight loss whereas some patients may manifest with nonspecific symptoms for a period of years or an acute emergency of perforation, obstruction, or hemorrhage. The clinical course of EATL is very unfavorable and the prognosis is poor. Both celiac sprue and EATL are very rare diseases in Asia, except India and Middle East. We report a 60-year-old male diagnosed as having EATL after segmental small bowel resection, who presented with recurrent gastrointestinal bleeding.
Celiac Disease/*complications ; Gastrointestinal Hemorrhage/*etiology ; Humans ; Intestinal Neoplasms/complications/*diagnosis/pathology ; Intestine, Small/pathology ; Lymphoma, T-Cell/complications/*diagnosis/pathology ; Male ; Middle Aged ; Recurrence